Department of Nursing, Chung-Ang University, Seoul 06974, Korea.
Int J Environ Res Public Health. 2021 Aug 24;18(17):8902. doi: 10.3390/ijerph18178902.
Warfarin is widely used as an oral anticoagulant. However, it is difficult to manage patients due to its narrow therapeutic range and individualized differences. Using controlled trials and real-world observational studies, this systematic review aimed to analyze health education's impact among patients on warfarin therapy by mobile application. Smartphone and tablet applications have the potential to actively educate patients by providing them with timely information through push notifications. MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane electronic databases were searched using the keywords "anticoagulants," "warfarin", "mobile application", and "smartphone" up to May 2020. Of the 414 articles obtained, 12 articles met the inclusion criteria for this review. The education and self-management programs using the mobile health application had diverse contents. A meta-analysis was not deemed appropriate because of the heterogeneity of populations, interventions, and outcomes. Thus, a narrative synthesis is presented instead. This review demonstrates that educating patients for anticoagulation management through their smartphones or tablets improves their knowledge levels, medication or treatment adherence, satisfaction, and clinical outcomes. Moreover, it has a positive effect on continuing health care. Future research concerning patients taking warfarin should include key self-management outcomes in larger, more rigorously designed studies, allowing for comparisons across studies. This study proposes a continuous application of timely education through smartphone applications to the current medical and nursing practice.
华法林被广泛用作口服抗凝剂。然而，由于其治疗范围狭窄和个体差异，患者的管理较为困难。本系统评价通过对照试验和真实世界观察性研究，旨在分析移动应用程序在华法林治疗中对患者进行健康教育的效果。智能手机和平板电脑应用程序通过推送通知为患者提供及时的信息，从而有可能积极地对患者进行教育。截至 2020 年 5 月，使用“抗凝剂”、“华法林”、“移动应用程序”和“智能手机”等关键词，在 MEDLINE、EMBASE、CINAHL、Web of Science 和 Cochrane 电子数据库中进行了搜索。在获得的 414 篇文章中，有 12 篇文章符合本综述的纳入标准。使用移动健康应用程序的教育和自我管理计划内容多样。由于人群、干预措施和结局存在异质性，因此不适合进行荟萃分析。因此，目前呈现的是叙述性综合。本综述表明，通过智能手机或平板电脑对患者进行抗凝管理教育可提高其知识水平、药物或治疗依从性、满意度和临床结局。此外，这对持续的医疗保健也有积极影响。未来有关服用华法林的患者的研究应包括关键的自我管理结局，以便在更大、设计更严格的研究中进行比较。本研究提出通过智能手机应用程序持续提供及时的教育，将其应用于当前的医疗和护理实践中。
