Oral Anticoagulation in Atrial Fibrillation: Development and Evaluation of a Mobile Health Application to Support Shared Decision-Making
Open Access
- 1 January 2017
- journal article
- research article
- Published by Sociedade Brasileira de Cardiologia in Arquivos Brasileiros de Cardiologia
- Vol. 110 (1), 7-14
- https://doi.org/10.5935/abc.20170181
Abstract
Background: Atrial fibrillation is responsible for one in four strokes, which may be prevented by oral anticoagulation, an underused therapy around the world. Considering the challenges imposed by this sort of treatment, mobile health support for shared decision-making may improve patients' knowledge and optimize the decisional process. Objective: To develop and evaluate a mobile application to support shared decision about thromboembolic prophylaxis in atrial fibrillation. Methods: We developed an application to be used during the clinical visit, including a video about atrial fibrillation, risk calculators, explanatory graphics and information on the drugs available for treatment. In the pilot phase, 30 patients interacted with the application, which was evaluated qualitatively and by a disease knowledge questionnaire and a decisional conflict scale. Results: The number of correct answers in the questionnaire about the disease was significantly higher after the interaction with the application (from 4.7 +/- 1.8 to 7.2 +/- 1.0, p < 0.001). The decisional conflict scale, administered after selecting the therapy with the app support, resulted in an average of 11 +/- 16/100 points, indicating a low decisional conflict. Conclusions: The use of a mobile application during medical visits on anticoagulation in atrial fibrillation improves disease knowledge, enabling a shared decision with low decisional conflict. Further studies are needed to confirm if this finding can be translated into clinical benefit.Keywords
This publication has 36 references indexed in Scilit:
- Educational Intervention Improves Anticoagulation Control in Atrial Fibrillation Patients: The TREAT Randomised TrialPLOS ONE, 2013
- Corrigendum to: 'Nurse-led care vs. usual care for patients with atrial fibrillation: results of a randomized trial of integrated chronic care vs. routine clinical care in ambulatory patients with atrial fibrillation' [Eur Heart J 2012; 33:2692-2699, doi:10.1093/eurheartj/ehs071]European Heart Journal, 2013
- Apixaban versus Warfarin in Patients with Atrial FibrillationThe New England Journal of Medicine, 2011
- Comparative Validation of a Novel Risk Score for Predicting Bleeding Risk in Anticoagulated Patients With Atrial Fibrillation: The HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) ScoreJournal of the American College of Cardiology, 2011
- An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortalityEP Europace, 2010
- Varfarina e femprocumona: experiência de um ambulatório de anticoagulaçãoArquivos Brasileiros de Cardiologia, 2010
- Uso crônico de anticoagulante oral: implicações para o controle de níveis adequadosArquivos Brasileiros de Cardiologia, 2009
- Perception of Risk and Knowledge of Risk Factors in Women at High Risk for StrokeStroke, 2009
- Do Increases in Patient Activation Result in Improved Self‐Management Behaviors?Health Services Research, 2006
- Patient Satisfaction with Health Care DecisionsMedical Decision Making, 1996