Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial
Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial
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用于心房颤动管理的移动医疗技术，集成决策支持、教育和患者参与：mAF 应用程序试用
DOI：
10.1016/j.amjmed.2017.07.003
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发表时间：
2017-12-01
影响因子：
5.9
通讯作者：
Lip, Gregory Y. H.
中科院分区：
文献类型：
--
作者：
Guo, Yutao;Chen, Yundai;Lip, Gregory Y. H.
背景：移动健康技术对房颤患者的管理尚不清楚。方法:简单的移动AF （mAF）应用程序旨在纳入临床决策支持工具（CHA2DS2-VASc[充血性心力衰竭，高血压，年龄= 75岁，糖尿病，既往中风或TIA，血管疾病，年龄65-74岁，性别类别]，HAS-BLED[高血压，肾/肝功能异常，中风，出血史或易感性，不稳定INR，老年，药物/酒精合并]，相同tt2r2[性别，年龄< 60岁，病史，治疗，吸烟，种族]评分），教育材料，患者参与策略与自我护理协议和结构化随访。在一项聚类随机设计的先导研究中，心房颤动患者被随机分为两组（mAF应用vs常规治疗）。在基线、1个月和3个月时评估患者的知识、生活质量、药物依从性和抗凝满意度。1个月时评估mAFApp的可用性、可行性和可接受性。结果：共有113例患者随机分为mAF App干预组（平均年龄67.4岁，男性57.5%，平均随访69天），96例患者随机分为常规护理组（平均年龄70.9岁，男性55.2%，平均随访95天）。超过90%的患者报告mAF应用程序简单，用户友好，有帮助，与常规护理组相比，知识显著提高（趋势P值）
BACKGROUND: Mobile Health technology for the management of patients with atrial fibrillation is unknown.METHODS: The simple mobile AF (mAF) App was designed to incorporate clinical decision-support tools (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age = 75 years, Diabetes Mellitus, Prior Stroke or TIA, Vascular disease, Age 65-74 years, Sex category], HAS-BLED [Hypertension, Abnormal renal/ liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly], SAMe-TT2R2 [Sex, Age < 60 years, Medical history, Treatment, Tobacco use, Race] scores), educational materials, and patient involvement strategies with self-care protocols and structured follow-up. Patients with atrial fibrillation were randomized into 2 groups (mAF App vs usual care) in a cluster randomized design pilot study. Patients' knowledge, quality of life, drug adherence, and anticoagulation satisfaction were evaluated at baseline, 1 month, and 3 months. Usability, feasibility, and acceptability of the mAFApp were assessed at 1 month.RESULTS: A total of 113 patients were randomized to mAF App intervention (mean age, 67.4 years; 57.5% were male; mean follow-up, 69 days), and 96 patients were randomized to usual care (mean age, 70.9 years; 55.2% were male; mean follow-up, 95 days). More than 90% of patients reported that the mAF App was easy, user-friendly, helpful, and associated with significant improvements in knowledge compared with the usual care arm (P values for trend