Department of Cardiac Surgery, West China Hospital, Sichuan University, Chendu, 610041, Sichuan, China.
Department of Cardiovascular Surgery, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
J Thromb Thrombolysis. 2019 Aug;48(2):263-269. doi: 10.1007/s11239-019-01859-0.
We developed a novel anticoagulation management system (Anticlot Assistant) based on a smartphone application (App). This study was performed to evaluate patient compliance with Anticlot Assistant. This prospective case series study involved patients receiving warfarin therapy. The eligible patients were managed via Anticlot Assistant, and outcome data were analyzed. Thirty patients were recruited. The mean time within the therapeutic range (TTR) was 56.5% ± 26.2% and the mean patient compliance with Anticlot Assistant was 52.7% ± 40.4%. The patients in good compliance group had higher TTR (65.6 ± 25.0% vs. 40.0 ± 21.0%, P = 0.009), lower time in the extremely low range (9.4 ± 10.6% vs. 27.4 ± 13.2%, P = 0.000) and in the extremely high range (1.3 ± 2.8% vs. 14.1 ± 22.3%, P = 0.004) than those in poor compliance group. Logistic regression analysis revealed that receiving an education of > 6 years was the only independent predictor of good compliance (odds ratio 8.400, 95% confidence interval 1.274-55.394, P = 0.027). Patient compliance is critical important for good outcomes and it might increase with improvements in education and more widespread use of information technology. Although further improvement is needed, Anticlot Assistant is promising and this study offered valuable experiences for further research.
我们开发了一种基于智能手机应用程序(App)的新型抗凝管理系统(Anticlot Assistant)。本研究旨在评估患者对 Anticlot Assistant 的依从性。这是一项前瞻性病例系列研究,涉及接受华法林治疗的患者。符合条件的患者通过 Anticlot Assistant 进行管理,并分析结果数据。共招募了 30 名患者。治疗范围内时间(TTR)的平均百分比为 56.5%±26.2%,Anticlot Assistant 的平均患者依从率为 52.7%±40.4%。依从性良好组的 TTR 更高(65.6%±25.0%比 40.0%±21.0%,P=0.009),极低范围时间(9.4%±10.6%比 27.4%±13.2%,P=0.000)和极高范围时间(1.3%±2.8%比 14.1%±22.3%,P=0.004)更低。Logistic 回归分析显示,接受超过 6 年的教育是良好依从性的唯一独立预测因素(比值比 8.400,95%置信区间 1.274-55.394,P=0.027)。患者的依从性对于良好的结果至关重要,并且随着教育的提高和信息技术的更广泛应用,依从性可能会增加。尽管还需要进一步改进,但 Anticlot Assistant 具有很大的发展潜力,本研究为进一步研究提供了有价值的经验。