Acute Myocardial Infarction (AMI)AMI-HOPENCT07443982
Acute Myocardial Infarction - Allied Health-Oriented Patient-centered Digitally-Enabled Care
A study testing Pharmacist-led digital platform assisted care in people with Acute Myocardial Infarction (AMI), run by National University Heart Centre, Singapore at 6 sites in Singapore.
Trial summary
The Acute Myocardial Infarction - allied Health Oriented, Patient centered, and digitally Enabled care (AMI-HOPE) program is a model of care designed to improve post-AMI well-being, safety, and outcomes through greater involvement of AHPs in patient care and integrating digital technologies into routine primary care… Read more about this study
- Who is it for?
- Ages 21 to 90 years
- Conditions the study is for
- Acute Myocardial Infarction (AMI)
- What is being tested?
- Pharmacist-led digital platform assisted care
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,633 participants
- Where
- 6 sitesSingapore
- Study dates
- 11 Jan 2023to 30 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or Female, aged 21 to 90 years (inclusive), at the time of signing the informed consent form
- Clinically diagnosed with AMI during index hospitalisation
- Own a mobile phone with internet access- intervention arm only
Who cannot join
- Patients who are planned for palliative care or life expectancy <1 year
- Foreigners who do not have Singaporean citizenship/ Permanent Resident (PR) status
- Patients who are enrolled into Healthier SG affiliated with General Practitioners (GPs)
- Allergy or intolerance of Angiotensin-Converting Enzyme Inhibitors (ACE-I) or Angiotensin II Receptor Blockers (ARB)
Trial locations and contacts
6 sites in 1 country.
6 sites in 1 country
Singapore6 sites
Changi General Hospital (CGH)
Singapore
Khoo Teck Puat Hospital (KTPH)
Singapore
National Heart Centre Singapore (NHCS)
Singapore
National University Heart Centre, Singapore (NUHCS)
Singapore
Ng Teng Fong General Hospital (NTFGH)
Singapore
Tan Tock Seng Hospital (TTSH)
Singapore
About this study
The Acute Myocardial Infarction - allied Health Oriented, Patient centered, and digitally Enabled care (AMI-HOPE) program is a model of care designed to improve post-AMI well-being, safety, and outcomes through greater involvement of AHPs in patient care and integrating digital technologies into routine primary care disease management. AMI-HOPE aims to deliver solutions to these identified gaps of care which will transform healthcare planning both at cluster and national levels. The cornerstone of the AMI-HOPE program will be upskilling pharmacists to take on low-intermediate complexity clinician roles during the post-discharge period. The first 6 months will be anchored by tertiary care before a handoff to primary care. This frees up cardiologists to focus on high complexity cases.
Read the detailed description
The AMI-HOPE program addresses three critical healthcare challenges: insufficient specialist capacity, limited outpatient clinic infrastructure, and excessive dependence on hospital-based rather than community-based care during the vulnerable early post-discharge period for myocardial infarction patients. The program trains pharmacists to provide comprehensive post-MI (Myocardial Infarction) care through personalized cardiovascular medication optimization, targeted interventions for patients with reduced ejection fraction, smoking cessation support, and lifestyle counseling covering diet and exercise. Care delivery occurs remotely through integrated digital health platforms that facilitate continuous vital signs monitoring, deliver structured patient education at strategic intervals, and promote effective self-management capabilities.
This proof-of-value stepped-wedge pragmatic trial that evaluates the effectiveness of the AMI-HOPE intervention is conducted across seven hospitals and eighteen primary care polyclinics spanning Singapore's three health clusters.
- Conditions
- Acute Myocardial Infarction (AMI)
- Being tested
- Standard of Care (SOC), Pharmacist-led digital platform assisted care
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard of Care (SOC)Other
Standard of care treatment without the pharmacist-led digital platform assisted care
Pharmacist-led digital platform assisted careOther
Up titration of medications by pharmacist. AMI-HOPE centers around a digital platform that offers continuous telemonitoring on patients' vitals, tailored medication prescription with support from pharmacists and personalised lifestyle nudges and educational material.
| Study group | Role | What they receive |
|---|---|---|
| Control | Other | Standard of Care Receives: Other: Standard of Care (SOC) |
| Pharmacist-led digital platform assisted care | Other | AMI-HOPE centers around a digital platform that offers continuous telemonitoring on patients' vitals, tailored medication prescription with support from pharmacists, and personalised lifestyle nudges and educational material. Receives: Other: Pharmacist-led digital platform assisted care |
What is being measured
The primary outcome is the main question the study is designed to answer.
Death and Unplanned Cardiovascular Disease (CVD) related (non-fatal MI, non-fatal stroke, others) rehospitalizations
Counts and time to any events of death or unplanned CVD related rehospitalizations
Measured: between enrolment and end of 12-month follow up
Secondary outcomes (11)
Absolute change in concentration of Low-Density Lipoprotein Cholesterol (LDL-C)
Absolute change in LDL-C (in mmol/L) from enrollment to end of 12 month follow up period
Measured: between enrolment and end of 12-month follow up
Change in Blood Pressure (BP)
Absolute change in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) (in mmHg) from enrollment to end of 12 month follow up period
Measured: At discharge, 2 week, 1, 3, 6, 9 &12 months
Change in Haemoglobin A1c (HbA1c)
Absolute change in HbA1c (in %) from enrollment to end of 12 month follow up period
Measured: between enrolment and end of 12-month follow up
EuroQoL (Quality of Life)-5 Dimensions (EQ-5D) Scores in Participants
EQ-5D was calculated to evaluate quality of life (QoL) in participants. EQ-5D is a participant answered questionnaire scoring 5 dimensions - mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The EQ-5D total score ranges from 0 (worst health state) to 1 (perfect health state) and 1 reflects the best outcome.
Measured: At 1 month and 12 month
Patient Activation Measure (PAM-13) Scores in Participants
The Patient Activation Measure 13 (PAM-13) is a non-disease-specific survey that assesses a patient's knowledge, skills, and confidence for self-management. It uses 13 items on a 4-point Likert scale, with the raw sum score (ranging from 13-52) being transformed into a standardized 0-100 metric.
Measured: At discharge and 6month
Seattle Angina Questionnaire-7 (SAQ-7) Scores in Participants
The change from baseline in Health-Related Quality of Life (HRQOL) is assessed by the SAQ-7. The SAQ-7 is a validated tool assessing three domains: physical limitation, angina frequency, and quality of life. An overall summary score is calculated by averaging the three domain scores (0-100), where higher scores indicate better health status (i.e., less frequent angina, better function, and higher quality of life).
Measured: At 1 month and 12 month
Patient Health Questionnaire-9 (PHQ-9) Scores in Participants
The PHQ-9 is a validated 9-item self-report instrument used for screening and assessing the severity of depression. Each item is scored from 0 ("not at all") to 3 ("nearly every day") based on symptom frequency over the past two weeks, yielding a total score from 0 to 27, with higher scores indicating greater depression severity.
Measured: At 1month and 12 month
Presence of angina pectoris as determined by the Rose Angina Questionnaire
The Rose Angina Questionnaire is a standardized, validated set of questions used to identify the presence of angina pectoris in epidemiological studies. It consists of a structured interview algorithm that classifies participants based on their responses to questions about chest pain characteristics, leading to a categorical outcome (e.g., definite angina, possible angina, or no angina).
Measured: At 1month and 12month
Dose of ACE/ARB/MRA inhibitor
Change in drug intensity score for ACE inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors (ACE I/ARB/ARNI) and beta blockers, to assess the effect of the pharmacist led intervention on prescription, early up titration, and adherence to drugs, and the subsequent impact on LDL C, blood pressure, HbA1c control, and left ventricular ejection fraction (LVEF).
Measured: At discharge, 1, 3, 6 &12 months
Percentage of patients smoking
Each patient would be asked to indicate whether they are currently an active smoker(yes/no) at each point of assessment (at 1,3, 6 \& 12 month). The change in percentage of active smoker in the duration of the programme is use to assess the effectiveness of the smoking cessation programme.
Measured: At 1,3, 6 & 12 month
Length of stay
To assess the clinical efficiency of the intervention
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Mar 2026
- Study start11 Jan 2023
- Primary completion30 Sep 2026 (estimated)
- Study completion30 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Acute Myocardial Infarction (AMI)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Step Wedge Trial
- Masking
- None (open label)
- Enrolment
- 1,633 participants (actual)
Sponsor and investigators
- Lead sponsor
- National University Heart Centre, Singapore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mark Chan, National University Heart Centre, Singapore
- Investigators
- Mark Chan, Principal investigator, National University Heart Centre, Singapore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07443982
- Sponsor's protocol ID
- PHRGTC-0003
- Acronym
- AMI-HOPE
- Status last verified
- Feb 2026
- First submitted
- 1 Feb 2026
- Last updated
- 2 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Wang M, Lim ZZ, Chan SP, Teo ZL, Tan SH, Panday V, Sze HJ, Wong YM, Chang G, Ng F, Syed I, Lim P, Huang Z, Lim Z, Teo V, Phoon I, Kunarso G, Chai SC, Siau KR, Kwan YS, Ho S, Lim L, Sim M, Yap HR, Oh WL, Chong HP, Yeo A, Deorani P, Morris R, Ho HH, Hausenloy DJ, Wee HL, Tan D, Chan MY. Pharmacist-led, digitally enabled transitional care after acute myocardial infarction: design and baseline characteristics of the AMI-HOPE nationwide stepped-wedge trial. Eur Heart J Digit Health. 2026 Jun 20;7(6):ztag094. doi: 10.1093/ehjdh/ztag094. eCollection 2026 Jul.
PubMed 42499410
Study at a glance
From the registry record, last updated by the sponsor on 2 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Acute Myocardial Infarction - Allied Health-Oriented Patient-centered Digitally-Enabled Care
- ClinicalTrials.gov ID
- NCT07443982
- Acronym / sponsor ID
- AMI-HOPE / PHRGTC-0003
- Conditions
- Acute Myocardial Infarction (AMI)
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 1,633 participants (actual)
- Lead sponsor
- National University Heart Centre, SingaporeUniversity, hospital or other
- Study start
- 11 Jan 2023 (actual)
- Primary completion
- 30 Sep 2026 (estimated)
- Study completion
- 30 Sep 2026 (estimated)
- First posted
- 2 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Acute Myocardial Infarction - allied Health Oriented, Patient centered, and digitally Enabled care (AMI-HOPE) program is a model of care designed to improve post-AMI well-being, safety, and outcomes through greater involvement of AHPs in patient care and integrating digital technologies into routine primary care disease management. AMI-HOPE aims to deliver solutions to these identified gaps of care which will transform healthcare planning both at cluster and national levels. The cornerstone of the AMI-HOPE program will be upskilling pharmacists to take on low-intermediate complexity clinician roles during the post-discharge period. The first 6 months will be anchored by tertiary care before a handoff to primary care. This frees up cardiologists to focus on high complexity cases.
Detailed description
The AMI-HOPE program addresses three critical healthcare challenges: insufficient specialist capacity, limited outpatient clinic infrastructure, and excessive dependence on hospital-based rather than community-based care during the vulnerable early post-discharge period for myocardial infarction patients. The program trains pharmacists to provide comprehensive post-MI (Myocardial Infarction) care through personalized cardiovascular medication optimization, targeted interventions for patients with reduced ejection fraction, smoking cessation support, and lifestyle counseling covering diet and exercise. Care delivery occurs remotely through integrated digital health platforms that facilitate continuous vital signs monitoring, deliver structured patient education at strategic intervals, and promote effective self-management capabilities.
This proof-of-value stepped-wedge pragmatic trial that evaluates the effectiveness of the AMI-HOPE intervention is conducted across seven hospitals and eighteen primary care polyclinics spanning Singapore's three health clusters.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Step Wedge Trial
| Arm | Type | Receives |
|---|---|---|
| Control | Other | Other: Standard of Care (SOC)Standard of Care |
| Pharmacist-led digital platform assisted care | Other | Other: Pharmacist-led digital platform assisted careAMI-HOPE centers around a digital platform that offers continuous telemonitoring on patients' vitals, tailored medication prescription with support from pharmacists, and personalised lifestyle nudges and educational material. |
Who may qualify
- Ages
- 21 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Male or Female, aged 21 to 90 years (inclusive), at the time of signing the informed consent form
- Clinically diagnosed with AMI during index hospitalisation
- Own a mobile phone with internet access- intervention arm only
Key exclusion criteria (4 listed)
- Patients who are planned for palliative care or life expectancy <1 year
- Foreigners who do not have Singaporean citizenship/ Permanent Resident (PR) status
- Patients who are enrolled into Healthier SG affiliated with General Practitioners (GPs)
- Allergy or intolerance of Angiotensin-Converting Enzyme Inhibitors (ACE-I) or Angiotensin II Receptor Blockers (ARB)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standard of Care (SOC)Standard of care treatment without the pharmacist-led digital platform assisted care | Other | Control |
| Pharmacist-led digital platform assisted careUp titration of medications by pharmacist. AMI-HOPE centers around a digital platform that offers continuous telemonitoring on patients' vitals, tailored medication prescription with support from pharmacists and personalised lifestyle nudges and educational material. | Other | Pharmacist-led digital platform assisted care |
Primary outcome
Death and Unplanned Cardiovascular Disease (CVD) related (non-fatal MI, non-fatal stroke, others) rehospitalizations
Time frame: between enrolment and end of 12-month follow up
Counts and time to any events of death or unplanned CVD related rehospitalizations
11 secondary outcomes
Absolute change in concentration of Low-Density Lipoprotein Cholesterol (LDL-C)
Time frame: between enrolment and end of 12-month follow up
Change in Blood Pressure (BP)
Time frame: At discharge, 2 week, 1, 3, 6, 9 &12 months
Change in Haemoglobin A1c (HbA1c)
Time frame: between enrolment and end of 12-month follow up
EuroQoL (Quality of Life)-5 Dimensions (EQ-5D) Scores in Participants
Time frame: At 1 month and 12 month
Patient Activation Measure (PAM-13) Scores in Participants
Time frame: At discharge and 6month
Seattle Angina Questionnaire-7 (SAQ-7) Scores in Participants
Time frame: At 1 month and 12 month
Patient Health Questionnaire-9 (PHQ-9) Scores in Participants
Time frame: At 1month and 12 month
Presence of angina pectoris as determined by the Rose Angina Questionnaire
Time frame: At 1month and 12month
Dose of ACE/ARB/MRA inhibitor
Time frame: At discharge, 1, 3, 6 &12 months
Percentage of patients smoking
Time frame: At 1,3, 6 & 12 month
Length of stay
Time frame: Baseline
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Mar 2026.
- Derived from this study: PubMed 42499410Wang M, Lim ZZ, Chan SP, Teo ZL, Tan SH, Panday V, Sze HJ, Wong YM, Chang G, Ng F, Syed I, Lim P, Huang Z, Lim Z, Teo V, Phoon I, Kunarso G, Chai SC, Siau KR, Kwan YS, Ho S, Lim L, Sim M, Yap HR, Oh WL, Chong HP, Yeo A, Deorani P, Morris R, Ho HH, Hausenloy DJ, Wee HL, Tan D, Chan MY. Pharmacist-led, digitally enabled transitional care after acute myocardial infarction: design and baseline characteristics of the AMI-HOPE nationwide stepped-wedge trial. Eur Heart J Digit Health. 2026 Jun 20;7(6):ztag094. doi: 10.1093/ehjdh/ztag094. eCollection 2026 Jul.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Mark Chan principal investigator
National University Heart Centre, Singapore
6 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Pharmacist-led digital platform assisted care in people with Acute Myocardial Infarction (AMI), run by National University Heart Centre, Singapore at 6 sites in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 2 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 6 sites in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Death and Unplanned Cardiovascular Disease (CVD) related (non-fatal MI, non-fatal stroke, others) rehospitalizations (time frame: between enrolment and end of 12-month follow up). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07443982, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2026.