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 YH ORCID: 0000-0002-7566-1626 et al (show 1 more authors) (2020) Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort. European Journal of Internal Medicine, 82. pp. 105-111.

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Abstract

<h4>Background</h4>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.<h4>Methods</h4>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'.<h4>Results</h4>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%.<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: Atrial fibrillation, Screening, Integrated care, Smart technology
Depositing User: Symplectic Admin
Date Deposited: 11 Feb 2021 11:09
Last Modified: 18 Jan 2023 23:00
DOI: 10.1016/j.ejim.2020.09.024
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3115496
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