Trial reportInternational journal of cardiology2025
The mobile health intervention for rural patients with atrial fibrillation a randomized controlled trial.
Trial report in International journal of cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The trial behind it
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Who cites it
5 citing papers in PubMed.
- Trial
- Integrated care management and comprehensive geriatric assessment using a mHealth-based approach in older multimorbid patients with atrial fibrillation: the AFFIRMO cluster-randomised trial.The Lancet regional health. Europe · 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
- Effect of Health Literacy on use of a Virtual Coach to Promote Home Blood Pressure Monitoring.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Promoting Family Communication for Cascade Cancer Genetic Testing With Relational Agent Role-Play: Quasi-Experimental Study.JMIR formative research · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundRural individuals with atrial fibrillation (AF) experience challenges to anticoagulation adherence and self-management of the condition. We tested an intervention to improve anticoagulation adherence, quality of life, and health care utilization in rural individuals with AF.
methodsWe randomized rural patients with AF receiving anticoagulation to receive a smartphone-based relational agent (for disease education and adherence guidance) and a heart rate and rhythm monitor for 4 months or a smartphone-based health education app. Adherence was determined with 12-month proportion of days covered (PDC), and secondary outcomes of quality of life and health care utilization from interviews and health records.
resultsThe trial randomized 270 individuals 1:1 (median [IQR] age 73.1 [67.5-78.6]; 163 [60.4 %] female sex). Over the 4-month intervention, intervention participants used the relational agent a median of 101 (IQR: 72, 110) days. In an intention-to-treat analysis there was no significant difference in 12-month PDC between the intervention and control groups (median [IQR]: intervention 0.97 [0.89-1.00] versus control 0.97 [0.92-1.00]) or in PDC ≥0.80. Intervention participants were more likely to self-report anticoagulation adherence than control at 4 and 8 months (95.7 % vs 88.4 % and 93.0 % vs 78.8 %, respectively) but not at 12 months. There were no significant differences by assigned intervention for the other secondary outcomes.
conclusionsRandomization to the relational agent intervention was not associated with improved PDC at 12-months but with greater interim self-reported adherence compared to a control. This study demonstrates the successful use of a smartphone-based agent to address adherence among rural individuals with AF.
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