Designing a Web-Based Psychological Intervention for Patients With Myocardial Infarction With Nonobstructive Coronary Arteries: User-Centered Design Approach (Preprint)

Abstract

BACKGROUND The involvement of patient research partners (PRPs) in research aims to safeguard the needs of patient groups and produce new interventions that are developed based on patient input. Myocardial infarction with non-obstructive coronary arteries (MINOCA), unlike acute myocardial infarction with obstructive coronary arteries (MI), is presented with no significant obstructive coronary artery disease. Patients with this diagnosis are a subset of those diagnosed with traditional MI and often need more psychological support, something that is presently not established in their current treatment scheme. An internet-delivered intervention might offer patients with MINOCA the opportunity to access psychological treatment remotely and tailored to their specific needs after MINOCA. OBJECTIVE To describe the development of a therapist-guided, internet-delivered, psychological intervention, designed specifically for patients with MINOCA. METHODS The study used a participatory design that involved seven PRPs diagnosed with MINOCA collaborating with a team consisting of researchers, cardiologists and psychologists. Intervention content was developed iteratively and presented to the PRPs across several prototypes, each continually adjusted and redesigned according to the feedback received. The intervention was presented to an expert panel of 2 clinical psychologists and a cardiologist for final input. RESULTS The outcome of the collaboration between PRPs and the research group produced an internet-based psychological 9-step program focusing on stress, worry and valued action. The input from PRPs contributed substantially to the therapy content, homework tasks, interactive activities, multimedia and design presentation. CONCLUSIONS Working with PRPs to develop an intervention for people with MINOCA produced a web-based intervention that can be further evaluated with the goal to offer a new psychological treatment option to a patient group currently without one. Direct contribution from patient research partners enabled us to obtain relevant, insightful and valuable feedback that was put towards the overall design and content of the intervention. The impact on those with MINOCA could be substantial.