{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:47Z","timestamp":1792785887982,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Innovative Health Initiative Joint Undertaking","award":["101112022"],"award-info":[{"award-number":["101112022"]}],"id":[{"id":"https:\/\/ror.org\/04afqts81","id-type":"ROR","asserted-by":"crossref"}]},{"name":"European Union\u2019s Horizon Europe research and innovation program"},{"name":"COCIR","id":[{"id":"https:\/\/ror.org\/0315a7e71","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100013322","name":"EFPIA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Vaccines Europe"},{"name":"EuropaBio","id":[{"id":"https:\/\/ror.org\/029pbd337","id-type":"ROR","asserted-by":"crossref"}]},{"name":"MedTech Europe"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sustained engagement is essential for remote patient management(RM) after acute coronary syndrome (ACS), yet self-monitoring behaviour differs across patients and may influence risk-factor control and clinical outcomes. The objectives are to assess whether previously identified adherence patterns could be reproduced in a larger cohort, whether healthcare worker outreach triggered by missing measurements (Medical Service Centre [MSC]) was associated with more sustained adherence, and whether these patterns were associated with differences in secondary-prevention outcomes and clinical events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this retrospective cohort study, patients enrolled in a post-ACS RM programme at a tertiary centre were included. Weekly use of three home-monitoring devices over 12 months was grouped into adherence patterns using time-series k-means clustering. Patients were categorized by enrolment before or after implementation of MSC-supported care. Blood pressure, lipids, body mass index (BMI), target attainment, and clinical events were analysed using generalized estimating equations. A total of 1181 patients were included. Three adherence patterns were identified and replicated, consistent with the patterns previously described as \u2018loyally persisting\u2019, \u2018temporarily persistent\u2019, and \u2018negligent quitting\u2019. After MSC implementation, the distribution shifted towards more favourable patterns, with more loyally persisting patients (P &amp;lt; 0.001). This pattern showed more favourable cardiometabolic profiles and, for BMI, triglycerides, and LDL cholesterol target attainment greater improvement over time. Clinical event rates did not differ significantly between patterns, although directional trends favoured the loyally persisting pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RM adherence patterns are reproducible and clinically meaningful after ACS, with potential value as behavioural markers for risk stratification and targeted support in secondary prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag486","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:38:35Z","timestamp":1788867515000},"source":"Crossref","is-referenced-by-count":0,"title":["Self-monitoring patterns after acute coronary syndrome: behavioural markers for secondary prevention"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-7330","authenticated-orcid":false,"given":"Wouter P M","family":"van der Loo","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Albinusdreef 2, Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim J","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Netherlands Organization for Applied Scientific Research , Digital Health Department, Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3613-5575","authenticated-orcid":false,"given":"Sara M","family":"Hondmann","sequence":"additional","affiliation":[{"name":"Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-2382","authenticated-orcid":false,"given":"Willem J","family":"van den Brink","sequence":"additional","affiliation":[{"name":"Netherlands Organization for Applied Scientific Research , Digital Health Department, Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3440-5036","authenticated-orcid":false,"given":"Nina L","family":"Haring","sequence":"additional","affiliation":[{"name":"Netherlands Organization for Applied Scientific Research , Digital Health Department, Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-6716","authenticated-orcid":false,"given":"Veronica R","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Leiden University Medical Centre , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9664-2985","authenticated-orcid":false,"given":"Douwe E","family":"Atsma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Albinusdreef 2, Leiden ,","place":["The Netherlands"]},{"name":"Faculty of Industrial Design Engineering, Delft University of Technology , Delft ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9125-4601","authenticated-orcid":false,"given":"Roderick W C","family":"Scherptong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Albinusdreef 2, Leiden ,","place":["The 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