ArticleEuropean heart journal. Digital health2026
Pharmacist-led, digitally enabled transitional care after acute myocardial infarction: design and baseline characteristics of the AMI-HOPE nationwide stepped-wedge trial.
Article in European heart journal. Digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07443982 (Acute Myocardial Infarction - Allied Health-Oriented Patient-centered Digitally-Enabled Care), which is not on this map. Not yet cited in PubMed.
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Acute Myocardial Infarction - Allied Health-Oriented Patient-centered Digitally-Enabled Care
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Abstract
Aims: To describe the design of AMI-HOPE, a pharmacist-led, digitally enabled transitional care intervention for patients after acute myocardial infarction (AMI), and its nationwide stepped-wedge cluster-randomized evaluation across Singapore's public healthcare system. Methods and results: AMI-HOPE is designed as a pragmatic, open-label trial across three health clusters (7 hospitals, 18 polyclinics) in which hospitals crossed over from standard cardiologist-led care to intervention at 3 month intervals. We utilize the Health Discovery+ (HD+) platform for remote vital signs monitoring, rule-based alerts, pharmacist-led teleconsultations, and automated patient education. Target N = 1512 (1:1 ratio); primary outcome is a hierarchical win ratio composite (CV death, MI, stroke, CV readmissions, low-density lipoprotein cholesterol, systolic blood pressure, HbA1c, patient-reported outcome measures). Secondary outcomes include guideline-directed medical therapy titration/adherence, LVEF, and cost-effectiveness. Enrolment completed in September 2025 (N = 1634 randomized; 810 control, 824 intervention). Baseline characteristics (N = 1492 in follow-up) showed a median age of 59 years, 12% female, 61% Chinese ethnicity. Twelve-month follow-up will complete on 30 September 2026. Conclusion: AMI-HOPE demonstrates a scalable, digitally enabled model shifting early post-AMI care from specialist-led clinics to pharmacists with remote monitoring. This nationwide trial evaluates its clinical efficacy, implementation, and value at population scale. ClinicalTrials.gov: NCT07443982.
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