Trial reportJournal of medical Internet research2024
Smartphone App for Improving Self-Awareness of Adherence to Edoxaban Treatment in Patients With Atrial Fibrillation (ADHERE-App Trial): Randomized Controlled Trial.
Trial report in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The mobile health intervention for rural patients with atrial fibrillation a randomized controlled trial.International journal of cardiology · 2025Trial
- Age-Friendly Design and Optimization of Digital Health Technologies for Medication Adherence in Older Adults With Chronic Diseases: Scoping Review.Journal of medical Internet research · 2026Article
- Smartphone-based mobile health impact on oral anticoagulation adherence, quality of life, and healthcare utilization in adult atrial fibrillation.World journal of methodology · 2026Article
- The Effectiveness of Digital Therapeutics Intervention in Oral Anticoagulation Management: A Systematic Review and Meta-analysis.Mayo Clinic proceedings. Digital health · 2026Article
- A pilot feasibility study of a tablet-based virtual community application with shared avatars for promoting health behavior change in older adult care facilities.Frontiers in digital health · 2026Article
- Adherence to oral thromboprophylaxis in atrial fibrillation: an overview for clinicians.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Enhancing Digital Health Interventions for Medication Adherence: Considerations for Broader Applicability and Long-Term Impact.Journal of medical Internet research · 2025Article
- An intervention study on the secondary prevention medication adherence of ischemic stroke patients based on the protection motivation theory combined with medication literacy education in the AI-HEALS: a randomized controlled trial protocol.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to oral anticoagulant therapy is essential to prevent ischemic stroke in patients with atrial fibrillation (AF).
objectiveThis study aimed to evaluate whether smartphone app-based interventions improve medication adherence in patients with AF.
methodsThis open-label, multicenter randomized controlled trial (ADHERE-App [Self-Awareness of Drug Adherence to Edoxaban Using an Automatic App Feedback System] study) enrolled patients with AF treated with edoxaban for stroke prevention. They were randomly assigned to app-conditioned feedback (intervention; n=248) and conventional treatment (control; n=250) groups. The intervention group received daily alerts via a smartphone app to take edoxaban and measure blood pressure and heart rate at specific times. The control group received only standard, guideline-recommended care. The primary end point was edoxaban adherence, measured by pill count at 3 or 6 months. Medication adherence and the proportion of adequate medication adherence, which was defined as ≥95% of continuous medication adherence, were evaluated.
resultsMedication adherence at 3 or 6 months was not significantly different between the intervention and control groups (median 98%, IQR 95%-100% vs median 98%, IQR 91%-100% at 3 months, P=.06; median 98%, IQR 94.5%-100% vs median 97.5%, IQR 92.8%-100% at 6 months, P=.15). However, the proportion of adequate medication adherence (≥95%) was significantly higher in the intervention group at both time points (76.8% vs 64.7% at 3 months, P=.01; 73.9% vs 61% at 6 months, P=.007). Among patients aged >65 years, the intervention group showed a higher medication adherence value and a higher proportion of adequate medication adherence (≥95%) at 6 months.
conclusionsThere was no difference in edoxaban adherence between the groups. However, the proportion of adequate medication adherence was higher in the intervention group, and the benefit of the smartphone app-based intervention on medication adherence was more pronounced among older patients than among younger patients. Given the low adherence to oral anticoagulants, especially among older adults, using a smartphone app may potentially improve medication adherence.
trial registrationInternational Clinical Trials Registry Platform KCT0004754; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=28496&search_page=L. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2021-048777.
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