Details

Autor(en) / Beteiligte

• Guo, Yutao
• Lane, Deirdre A.
• Wang, Limin
• Zhang, Hui
• Wang, Hao
• Zhang, Wei
• Wen, Jing
• Xing, Yunli
• Wu, Fang
• Xia, Yunlong
• Liu, Tong
• Wu, Fan
• Liang, Zhaoguang
• Liu, Fan
• Zhao, Yujie
• Li, Rong
• Li, Xin
• Zhang, Lili
• Guo, Jun
• Burnside, Girvan
• Chen, Yundai
• Lip, Gregory Y.H.
• Wang, Liming
• Eckstein, Jens
• Thomas, G Neil
• Tong, Liu
• Mei, Feng
• Xuejun, Liu
• Xiaoming, Li
• Zhaoliang, Shan
• Xiangming, Shi
• Wei, Zhang
• Yunli, Xing
• Jing, Wen
• Fan, Wu
• Sitong, Yang
• Xiaoqing, Jin
• Bo, Yang
• Xiaojuan, Bai
• Yuting, Jiang
• Yangxia, Liu
• Yingying, Song
• Zhongju, Tan
• Li, Yang
• Tianzhu, Luan
• Chunfeng, Niu
• Lili, Zhang
• Shuyan, Li
• Zulu, Wang
• Bing, Xv
• Liming, Liu
• Yuanzhe, Jin
• Yunlong, Xia
• Xiaohong, Chen
• Fang, Wu
• Lina, Zhong
• Yihong, Sun
• Shujie, Jia
• Jing, Li
• Nan, Li
• Shijun, Li
• Huixia, Liu
• Rong, Li
• Fan, Liu
• Qingfeng, Ge
• Tianyun, Guan
• Yuan, Wen
• Xin, Li
• Yan, Ren
• Xiaoping, Chen
• Ronghua, Chen
• Yun, Shi
• Yulan, Zhao
• Haili, Shi
• Yujie, Zhao
• Quanchun, Wang
• Weidong, Sun
• Lin, Wei
• Chan, Esther
• Guangliang, Shan
• Chen, Yao
• Wei, Zong
• Dandi, Chen
• Xiang, Han
• Anding, Xu
• Xiaohan, Fan
• Ziqiang, Yu
• Xiang, Gu
• Fulin, Ge

Titel

Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation

Ist Teil von

• Journal of the American College of Cardiology, 2020-04, Vol.75 (13), p.1523-1534

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Current management of patients with atrial fibrillation (AF) is limited by low detection of AF, non-adherence to guidelines, and lack of consideration of patients’ preferences, thus highlighting the need for a more holistic and integrated approach to AF management. The objective of this study was to determine whether a mobile health (mHealth) technology-supported AF integrated management strategy would reduce AF-related adverse events, compared with usual care. This is a cluster randomized trial of patients with AF older than 18 years of age who were enrolled in 40 cities in China. Recruitment began on June 1, 2018 and follow-up ended on August 16, 2019. Patients with AF were randomized to receive usual care, or integrated care based on a mobile AF Application (mAFA) incorporating the ABC (Atrial Fibrillation Better Care) Pathway: A, Avoid stroke; B, Better symptom management; and C, Cardiovascular and other comorbidity risk reduction. The primary composite outcome was a composite of stroke/thromboembolism, all-cause death, and rehospitalization. Rehospitalization alone was a secondary outcome. Cardiovascular events were assessed using Cox proportional hazard modeling after adjusting for baseline risk. There were 1,646 patients allocated to mAFA intervention (mean age, 67.0 years; 38.0% female) with mean follow-up of 262 days, whereas 1,678 patients were allocated to usual care (mean age, 70.0 years; 38.0% female) with mean follow-up of 291 days. Rates of the composite outcome of ‘ischemic stroke/systemic thromboembolism, death, and rehospitalization’ were lower with the mAFA intervention compared with usual care (1.9% vs. 6.0%; hazard ratio [HR]: 0.39; 95% confidence interval [CI]: 0.22 to 0.67; p < 0.001). Rates of rehospitalization were lower with the mAFA intervention (1.2% vs. 4.5%; HR: 0.32; 95% CI: 0.17 to 0.60; p < 0.001). Subgroup analyses by sex, age, AF type, risk score, and comorbidities demonstrated consistently lower HRs for the composite outcome for patients receiving the mAFA intervention compared with usual care (all p < 0.05). An integrated care approach to holistic AF care, supported by mHealth technology, reduces the risks of rehospitalization and clinical adverse events. (Mobile Health [mHealth] technology integrating atrial fibrillation screening and ABC management approach trial; ChiCTR-OOC-17014138). [Display omitted]