{"id":"b87adf694ac3","type":"article","url":"https://hartvaat.nl/2020/04/07/mobiele-gezondheidstechnologie-voor-af-zorg/","title":"Mobiele gezondheidstechnologie voor AF-zorg","title_en":"Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2020.01.052","source_url":"https://doi.org/10.1016/j.jacc.2020.01.052","authors":["Yutao Guo","Deirdre A Lane","Limin Wang","Hui Zhang","Hao Wang","Wei Zhang","Jing Wen","Yunli Xing","Fang Wu","Yunlong Xia","Tong Liu","Fan Wu","Zhaoguang Liang","Fan Liu","Yujie Zhao","Rong Li","Xin Li","Lili Zhang","Jun Guo","Girvan Burnside","Yundai Chen","Gregory Y H Lip"],"significance":6,"published":"2020-04-07","source_date":"2020-04-07","image":"","kennis":[],"congress":"","summary_en":"This study evaluated mobile health technology for improving AF care, showing that smartphone-based monitoring, medication reminders, and teleconsultation can improve guideline adherence and clinical outcomes.","created":"2026-07-03T10:28:30Z","updated":"2026-07-03T13:27:40Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de rol van mobiele gezondheidstechnologie voor het verbeteren van AF-zorg.","abstract_original":"BACKGROUND: Current management of patients with atrial fibrillation (AF) is limited by low detection of AF, non-adherence to guidelines, and lack of consideration of patients' preferences, thus highlighting the need for a more holistic and integrated approach to AF management. OBJECTIVE: The objective of this study was to determine whether a mobile health (mHealth) technology-supported AF integrated management strategy would reduce AF-related adverse events, compared with usual care. METHODS: This is a cluster randomized trial of patients with AF older than 18 years of age who were enrolled in 40 cities in China. Recruitment began on June 1, 2018 and follow-up ended on August 16, 2019. Patients with AF were randomized to receive usual care, or integrated care based on a mobile AF Application (mAFA) incorporating the ABC (Atrial Fibrillation Better Care) Pathway: A, Avoid stroke; B, Better symptom management; and C, Cardiovascular and other comorbidity risk reduction. The primary composite outcome was a composite of stroke/thromboembolism, all-cause death, and rehospitalization. Rehospitalization alone was a secondary outcome. Cardiovascular events were assessed using Cox proportional hazard modeling after adjusting for baseline risk. RESULTS: There were 1,646 patients allocated to mAFA intervention (mean age, 67.0 years; 38.0% female) with mean follow-up of 262 days, whereas 1,678 patients were allocated to usual care (mean age, 70.0 years; 38.0% female) with mean follow-up of 291 days. Rates of the composite outcome of 'ischemic stroke/systemic thromboembolism, death, and rehospitalization' were lower with the mAFA intervention compared with usual care (1.9% vs. 6.0%; hazard ratio [HR]: 0.39; 95% confidence interval [CI]: 0.22 to 0.67; p < 0.001). Rates of rehospitalization were lower with the mAFA intervention (1.2% vs. 4.5%; HR: 0.32; 95% CI: 0.17 to 0.60; p < 0.001). Subgroup analyses by sex, age, AF type, risk score, and comorbidities demonstrated consistently lower HRs for the composite outcome for patients receiving the mAFA intervention compared with usual care (all p < 0.05). CONCLUSIONS: An integrated care approach to holistic AF care, supported by mHealth technology, reduces the risks of rehospitalization and clinical adverse events. (Mobile Health [mHealth] technology integrating atrial fibrillation screening and ABC management approach trial; ChiCTR-OOC-17014138)."}