TY  - JOUR
AU  - Arutyunov, Gregory P
AU  - Arutyunov, Alexander G
AU  - Ageev, Fail T
AU  - Fofanova, Tatiana V
PY  - 2022
DA  - 2022/7/25
TI  - Use of Digital Technology Tools to Characterize Adherence to Prescription-Grade Omega-3 Polyunsaturated Fatty Acid Therapy in Postmyocardial or Hypertriglyceridemic Patients in the DIAPAsOn Study: Prospective Observational Study
JO  - JMIR Cardio
SP  - e37490
VL  - 6
IS  - 2
KW  - primary care
KW  - research
KW  - myocardial infarction
KW  - cardiology
KW  - heart
KW  - cardiac
KW  - cardiac health
KW  - digital health
KW  - electronic patient engagement
KW  - eHealth
KW  - patient engagement
KW  - clinical report
KW  - treatment
KW  - treatment adherence
AB  - Background: Maintaining sustained adherence to medication for optimal management of chronic noninfectious diseases, such as atherosclerotic vascular disease, is a well-documented therapeutic challenge. Objective: The DIAPAsOn study was a 6-month, multicenter prospective observational study in the Russian Federation that examined adherence to a preparation of highly purified omega-3 polyunsaturated fatty acids (Omacor) in 2167 adult patients with a history of recent myocardial infarction or endogenous hypertriglyceridemia. Methods: A feature of DIAPAsOn was the use of a bespoke electronic patient engagement and data collection system to monitor adherence. Adherence was also monitored by enquiry at clinic visits. A full description of the study’s aims and methods has appeared in JMIR Research Protocols. Results: The net average reduction from baseline in both total and low-density lipoprotein cholesterol was approximately 1 mmol/L and the net average increase in high-density lipoprotein cholesterol was 0.2 (SD 0.53) mmol/L (P<.001 for all outcomes vs baseline). The mean triglyceride level was 3.0 (SD 1.3) mmol/L at visit 1, 2.0 (SD 0.9) mmol/L at visit 2, and 1.7 (SD 0.7) mmol/L at visit 3 (P<.001 for later visits vs visit 1). The percentage of patients with a triglyceride level <1.7 mmol/L rose from 13.1% (282/2151) at baseline to 54% (1028/1905) at the end of the study. Digital reporting of adherence was registered by 8.3% (180/2167) of patients; average scores indicted poor adherence. However, a clinic-based enquiry suggested high levels of adherence. Data on health-related quality of life accrued from digitally engaged patients identified improvements among patients reporting high adherence to study treatment, but patient numbers were small. Conclusions: The lipid and lipoprotein findings indicate that Omacor had nominally favorable effects on the blood lipid profile. Less than 10% of patients enrolled in DIAPAsOn used the bespoke digital platform piloted in the study, and the level of self-reported adherence to medication by these patients was also low. Reasons for this low uptake and adherence are unclear. Better adherence was recorded in clinical reports. Trial Registration: ClinicalTrials.gov NCT03415152; https://clinicaltrials.gov/ct2/show/NCT03415152 
SN  - 2561-1011
UR  - https://cardio.jmir.org/2022/2/e37490
UR  - https://doi.org/10.2196/37490
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35877173
DO  - 10.2196/37490
ID  - info:doi/10.2196/37490
ER  -