OBJECTIVE Many acute coronary syndrome (ACS) patients are nonadherent to cardiovascular medications despite their known benefits for lowering risk of recurrent cardiovascular events. Research suggests that greater cardiac-related fear of recurrence (FoR) may be associated with higher nonadherence to cardiovascular medications and avoidance of physical activity. We aim to test the effect of an intervention that targets FoR as a potentially modifiable mechanism underlying nonadherence to recommended health behaviors among patients with suspected ACS. METHOD The INFORM trial ("INvestigating Fear Of Recurrence as a modifiable Mechanism of behavior change to improve medication adherence in acute coronary syndrome patients") is a double-blind, parallel-group randomized clinical trial. It compares an 8-session, at-home, electronic tablet-delivered, cognitive bias modification training (CBMT) intervention with a sham control. Patients who experience high perceived threat at the time of presentation to the emergency department (ED) with a suspected ACS are enrolled and randomized within 6 weeks of their ED visit. The primary outcome, FoR, is measured by the adapted Concerns about Recurrent ACS Scale. The trial also tests the intervention's effect on a potential mechanism of health behavior change that is inversely correlated with fear: an expansive future time perspective. Additional outcomes include electronically measured adherence to a cardiovascular medication and self-reported physical activity. CONCLUSIONS This study takes a mechanistic approach to addressing the dangerous problem of poor health behaviors after ACS. The trial will test whether targeting FoR or future time perspective by CBMT is a promising approach to improving nonadherence after ACS. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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急性心脏事件后对恐惧的干预：INFORM随机临床试验的原理和设计。

目的许多急性冠状动脉综合征（ACS）患者不坚持使用心血管药物，尽管它们具有降低复发性心血管事件风险的已知益处。研究表明，与心脏相关的更高的复发恐惧（FoR）可能与对心血管药物的不依从性增加和避免体育锻炼有关。我们的目的是测试以FoR为目标的干预措施的效果，该干预措施是潜在的可修改机制，其基础是怀疑ACS患者不遵守建议的健康行为。方法INFORM试验（“研究对复发的恐惧作为一种行为改变的可改善机制，以改善急性冠脉综合征患者的用药依从性”）是一项双盲，平行分组的随机临床试验。它比较了在家进行的8次会话 电子平板电脑提供的，具有假控制的认知偏差修正训练（CBMT）干预。在急诊室（ED）就诊时，如果他们怀疑是ACS，在感觉高度威胁的患者中入组并随机分组。主要结果FoR由适应性ACS复发量表的关注度来衡量。该试验还测试了干预措施对健康行为改变与恐惧成反比的潜在机制的影响：广阔的未来时间观点。其他结果包括电子测量对心血管药物的依从性和自我报告的身体活动。结论本研究采用机械方法解决了ACS后不良健康行为的危险问题。该试验将测试CBMT是否针对FoR或未来时间观点是否是改善ACS后不依从性的有前途的方法。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。