Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Am Heart J. 2022 Oct;252:16-25. doi: 10.1016/j.ahj.2022.05.023. Epub 2022 Jun 9.
Atrial fibrillation (AF) is a highly morbid condition which requires long-term adherence to oral anticoagulation and may be associated with adverse quality of life and health care utilization. We developed a relational agent-an interactive smartphone-based intervention accessible regardless of digital or health literacy-to assist individuals residing in rural, Western Pennsylvania, with AF with chronic disease self-management.
The "Mobile health intervention for rural atrial fibrillation" is a single center, parallel-arm randomized clinical trial for adults with AF funded by the National Institute of Health's National Heart, Lung, and Blood Institute to enroll 264 participants. All participants receive a smartphone with data plan: The intervention is a 4 month relational agent coupled with the AliveCor Kardia for heart rate and rhythm monitoring provided by smartphone, and the control a pre-installed, smartphone-based application for health-related information (WebMD). The study uses remote recruitment and engagement to enroll individuals who would otherwise be unlikely to participate in clinical research due to rurality. The primary outcome of the trial is adherence to oral anticoagulation, determined by proportion of days covered, as measured at 12 months. The secondary outcomes are quality of life, both AF-specific and general, and health care utilization. The study entails a baseline visit, a 4 month intervention phase, and 8 and 12 month follow-up visits.
This mobile health trial tests the effectiveness of a smartphone-based relational agent to improve clinical and patient-reported outcomes in rural-dwelling individuals.
心房颤动（AF）是一种高度病态的疾病，需要长期服用口服抗凝剂，可能会导致生活质量下降和医疗保健利用增加。我们开发了一种关系型代理——一种基于智能手机的互动干预措施，无论数字素养或健康素养如何，都可以为居住在宾夕法尼亚州西部农村地区的 AF 患者提供慢性病自我管理的帮助。
“农村心房颤动的移动医疗干预”是一项由美国国立卫生研究院国家心脏、肺和血液研究所资助的、针对成年人 AF 的单中心、平行臂随机临床试验，计划招募 264 名参与者。所有参与者都将获得一部带有数据计划的智能手机：干预措施是一个 4 个月的关系型代理，与通过智能手机提供的 AliveCor Kardia 心率和节律监测相结合，而对照组则是一个预安装的智能手机应用程序，提供与健康相关的信息（WebMD）。该研究利用远程招募和参与，招募那些由于地处农村而不太可能参与临床研究的个体。试验的主要结果是口服抗凝剂的依从性，通过覆盖率来衡量，在 12 个月时进行测量。次要结果是生活质量，包括 AF 特异性和一般生活质量，以及医疗保健的利用。该研究包括基线访问、4 个月的干预阶段以及 8 个月和 12 个月的随访访问。
这项移动医疗试验测试了基于智能手机的关系型代理在改善农村居民临床和患者报告结果方面的有效性。
