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J Med Internet Res. 2024;26:e65010.

Smartphone App for Improving Self-Awareness of Adherence to Edoxaban Treatment in Patients With Atrial Fibrillation (ADHERE-App Trial): Randomized Controlled Trial.

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제1저자 윤민재 · 교신저자 최동주

PMID 39570659 PMC11621717 DOI 10.2196/65010 IF 8.2 순환기내과
소속 (11)
  1. Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  2. Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.
  3. Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
  4. Department of Cardiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
  5. Division of Cardiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
  6. Department of Cardiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
  7. Division of Cardiology, Department of Internal Medicine, Bundang CHA Medical Center, CHA University, Seongnam, Republic of Korea.
  8. Division of Cardiology, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
  9. Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  10. Department of Computer Science and Engineering, Kyung Hee University, Yongin, Republic of Korea.
  11. Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway.

Abstract

BACKGROUND Adherence to oral anticoagulant therapy is essential to prevent ischemic stroke in patients with atrial fibrillation (AF).

OBJECTIVE This study aimed to evaluate whether smartphone app-based interventions improve medication adherence in patients with AF.

METHODS This 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.

RESULTS Medication 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.

CONCLUSIONS There 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 REGISTRATION International 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.

©Minjae Yoon, Ji Hyun Lee, In-Cheol Kim, Ju-Hee Lee, Mi-Na Kim, Hack-Lyoung Kim, Sunki Lee, In Jai Kim, Seonghoon Choi, Sung-Ji Park, Taeho Hur, Musarrat Hussain, Sungyoung Lee, Dong-Ju Choi. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 21.11.2024.

Keywords

anticoagulantsatrial fibrillationdigital healthmedication adherencemobile appsmobile phone

Figures

Figure 1
Figure 1 CONSORT (Consolidated Standards of Reporting Trials) flow diagram.
Figure 2
Figure 2 Medication adherence according to treatment groups. (A) Medication adherence at 6 months and (B) proportion of patients achieving adequate medication adherence (≥95%) at 6 months.

그림 출처: PubMed Central 공개 논문 (PMC11621717)

Conflict of interest statement

Conflicts of Interest: None declared.

그 밖의 정보
출판 형태
Journal Article, Randomized Controlled Trial, Multicenter Study, Research Support, Non-U.S. Gov't
저널
Journal of medical Internet research · eISSN 1438-8871
전자 출판
2024-11-21
MeSH
Humans · Atrial Fibrillation* / drug therapy · Thiazoles* / therapeutic use / administration & dosage · Male · Aged · Female · Smartphone* · Pyridines* / therapeutic use · Middle Aged · Mobile Applications · Anticoagulants / therapeutic use / administration & dosage · Factor Xa Inhibitors / therapeutic use / administration & dosage · Drug Monitoring*
Substances
edoxaban · Thiazoles · Pyridines · Anticoagulants · Factor Xa Inhibitors
데이터
CRiS: KCT0004754, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=28496&search_page=L
참고문헌
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