{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:00:15Z","timestamp":1791403215603,"version":"4.3.3"},"reference-count":59,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Medication nonadherence after percutaneous coronary intervention (PCI) remains a major barrier to secondary prevention. Prior SMS text messaging interventions have shown inconsistent results, often limited to reminders without addressing behavioral or psychological determinants.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effectiveness of a theory-informed, WeChat-based messaging intervention for improving medication adherence and patient-reported outcomes after PCI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A nonrandomized quasi-experimental parallel-group study was conducted from July 2022 to March 2023 at a tertiary hospital in Hangzhou, China. Patients were allocated by ward admission to the intervention or control group. The intervention comprised 12-week WeChat-based medication reminders and theory-informed messages mapped to capability, opportunity, and motivation\u2013behavior model domains and behavior change techniques. The primary outcome was medication adherence measured using the 8-item Morisky Medication Adherence Scale (MMAS-8); secondary outcomes were medication beliefs, self-efficacy, and disease-specific health status measured using the Beliefs About Medicines Questionnaire (BMQ)\u2013Specific, Self-Efficacy for Appropriate Medication Use Scale, and Seattle Angina Questionnaire (SAQ), respectively. Outcomes were assessed at baseline and 12 weeks by blinded assessors and analyzed using baseline-adjusted analysis of covariance based on the observed outcome data for all 92 participants. Sensitivity analyses included a per-protocol analysis restricted to the 87 participants who completed the full assigned care protocol and a difference-in-differences analysis comparing changes from baseline to 12 weeks between groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 180 patients screened, 92 (51.1%) were enrolled, of whom all completed the 12-week outcome assessment and 87 (94.6%) completed the full assigned care protocol. At 12 weeks, medication adherence was higher in the intervention group than in the control group (adjusted mean MMAS-8 score 7.40, SE 0.05 vs 6.22, SE 0.10; adjusted mean difference 1.18, 95% CI 0.96\u20101.40;\n P<\/jats:italic>\n <.001). Secondary outcomes generally favored the intervention, including the BMQ necessity (adjusted mean difference 1.62, 95% CI 1.06\u20102.17) and concerns (adjusted mean difference \u22123.25, 95% CI \u22123.87 to \u22122.63) subscales, medication self-efficacy (adjusted mean difference 4.04, 95% CI 3.21\u20104.87), and the SAQ summary score (adjusted mean difference 6.13, 95% CI 4.72\u20107.53;\n P<\/jats:italic>\n <.001 in all cases). SAQ treatment satisfaction did not differ significantly between groups (adjusted mean difference 0.40, 95% CI \u22122.02 to 2.82;\n P<\/jats:italic>\n =.74). Both the per-protocol and difference-in-differences sensitivity analyses yielded findings consistent with the primary analysis, supporting the robustness of the results.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A theory-informed, WeChat-based messaging intervention was associated with improvements in medication adherence, medication beliefs, self-efficacy, and disease-specific health status after PCI. Larger, adequately powered randomized trials with longer follow-up are needed to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/85192","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:25:05Z","timestamp":1786375505000},"page":"e85192-e85192","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a Behavior Change Wheel\u2013Informed WeChat-Based Messaging Intervention to Improve Medication Adherence After Percutaneous Coronary Intervention: 12-Week Quasi-Experimental 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