Cargando…
Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort
Background. In the mobile Atrial Fibrillation App (mAFA)-II trial, the use of mobile health (mHealth) technology, incorporating AF screening and integrated management strategy, was associated with improved short-term clinical outcomes. The aim of this study was to report adherence/persistence and lo...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Federation of Internal Medicine. Published by Elsevier B.V.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553102/ https://www.ncbi.nlm.nih.gov/pubmed/33067121 http://dx.doi.org/10.1016/j.ejim.2020.09.024 |
_version_ | 1783593535452217344 |
---|---|
author | Guo, Yutao Guo, Jun Shi, Xiangmin Yao, Yuan Sun, Yihong Xia, Yunlong Yu, Bo Liu, Tong Chen, Yundai Lip, Gregory Y H |
author_facet | Guo, Yutao Guo, Jun Shi, Xiangmin Yao, Yuan Sun, Yihong Xia, Yunlong Yu, Bo Liu, Tong Chen, Yundai Lip, Gregory Y H |
author_sort | Guo, Yutao |
collection | PubMed |
description | Background. In the mobile Atrial Fibrillation App (mAFA)-II trial, the use of mobile health (mHealth) technology, incorporating AF screening and integrated management strategy, was associated with improved short-term clinical outcomes. The aim of this study was to report adherence/persistence and long term (≥1 year) clinical outcomes of the mAFA-II trial, with mHealth-supported optimised stroke prevention, symptom control and comorbidity management. Methods. We studied an adult population screened for AF, where identified patients could enter a structured program of holistic and integrated care based on the ABC (Atrial fibrillation Better Care) pathway using mHealth with a mAFA intervention. In this cluster randomised trial, comparing mHeath intervention to usual care, the primary composite outcome was ‘stroke/thromboembolism, all-cause death and rehospitalization’. Results. The 1261 subjects (mean age 67.0 years, 38.0% female) who were followed up over one year (mean follow-up 687 (standard deviation, SD 191) days) in the intervention arm, had a lower risk of the composite outcome of ‘ischaemic stroke/systemic thromboembolism, death, and rehospitalization’ (hazard ratio, HR 0.18, 95% confidence interval, CI: 0.13–0.25, P < 0.001), compared to usual care (1212 subjects, mean age 70.1 years, 42.1% female). Of 842 patients using their smart devices for ‘Better symptom management’, 70.8% had good management adherence (monitoring time/follow-up since initial monitoring ≥ 70%), with the persistence of use of 91.7%. Conclusion. Amongst AF patients with long term use (≥1 year) of mHealth technology for optimising stroke prevention, symptom control and comorbidity management, adherence/persistence was good and associated with a reduction in adverse clinical outcomes. |
format | Online Article Text |
id | pubmed-7553102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | European Federation of Internal Medicine. Published by Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75531022020-10-13 Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort Guo, Yutao Guo, Jun Shi, Xiangmin Yao, Yuan Sun, Yihong Xia, Yunlong Yu, Bo Liu, Tong Chen, Yundai Lip, Gregory Y H Eur J Intern Med Original Article Background. In the mobile Atrial Fibrillation App (mAFA)-II trial, the use of mobile health (mHealth) technology, incorporating AF screening and integrated management strategy, was associated with improved short-term clinical outcomes. The aim of this study was to report adherence/persistence and long term (≥1 year) clinical outcomes of the mAFA-II trial, with mHealth-supported optimised stroke prevention, symptom control and comorbidity management. Methods. We studied an adult population screened for AF, where identified patients could enter a structured program of holistic and integrated care based on the ABC (Atrial fibrillation Better Care) pathway using mHealth with a mAFA intervention. In this cluster randomised trial, comparing mHeath intervention to usual care, the primary composite outcome was ‘stroke/thromboembolism, all-cause death and rehospitalization’. Results. The 1261 subjects (mean age 67.0 years, 38.0% female) who were followed up over one year (mean follow-up 687 (standard deviation, SD 191) days) in the intervention arm, had a lower risk of the composite outcome of ‘ischaemic stroke/systemic thromboembolism, death, and rehospitalization’ (hazard ratio, HR 0.18, 95% confidence interval, CI: 0.13–0.25, P < 0.001), compared to usual care (1212 subjects, mean age 70.1 years, 42.1% female). Of 842 patients using their smart devices for ‘Better symptom management’, 70.8% had good management adherence (monitoring time/follow-up since initial monitoring ≥ 70%), with the persistence of use of 91.7%. Conclusion. Amongst AF patients with long term use (≥1 year) of mHealth technology for optimising stroke prevention, symptom control and comorbidity management, adherence/persistence was good and associated with a reduction in adverse clinical outcomes. European Federation of Internal Medicine. Published by Elsevier B.V. 2020-12 2020-10-13 /pmc/articles/PMC7553102/ /pubmed/33067121 http://dx.doi.org/10.1016/j.ejim.2020.09.024 Text en © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Guo, Yutao Guo, Jun Shi, Xiangmin Yao, Yuan Sun, Yihong Xia, Yunlong Yu, Bo Liu, Tong Chen, Yundai Lip, Gregory Y H Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title | Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title_full | Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title_fullStr | Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title_full_unstemmed | Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title_short | Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort |
title_sort | mobile health technology-supported atrial fibrillation screening and integrated care: a report from the mafa-ii trial long-term extension cohort |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553102/ https://www.ncbi.nlm.nih.gov/pubmed/33067121 http://dx.doi.org/10.1016/j.ejim.2020.09.024 |
work_keys_str_mv | AT guoyutao mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT guojun mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT shixiangmin mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT yaoyuan mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT sunyihong mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT xiayunlong mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT yubo mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT liutong mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT chenyundai mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT lipgregoryyh mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort AT mobilehealthtechnologysupportedatrialfibrillationscreeningandintegratedcareareportfromthemafaiitriallongtermextensioncohort |