D-WEP-03 - Smart Watches Significantly Improve Adherence To Oral Anticoagulation Therapy Among Patients With Atrial Fibrillation: A Multicenter, Prospective Randomized Controlled Trial (ID 822)
Background: Long-term oral anticoagulation (OAC) therapy can significantly reduce thromboembolic complications in patients with atrial fibrillation (AF). However, adherence to therapy is a challenge for patients who receive this treatment.
Objective: To evaluate the effects of a smart watch that can send medication reminders on long-term OAC adherence in patients with AF.
Methods: In this multicenter, prospective randomized controlled trial, 160 patients with AF who were prescribed long-term OAC therapy were randomly divided into 2 groups: the smart watch reminder group and the standard care group. Both groups received regular follow-up calls and were scheduled for outpatient visits. In the smart watch reminder group, OAC adherence was also ensured by a smart watch with daily intake reminders, an intake error (including delayed or missed doses) alarm, as well as an immediate telephone feedback function. The Morisky Medication Adherence Scale (MMAS-8), a self-reported adherence measure, and the proportion of days covered (PDC), an objective measure, were used to evaluate adherence to OAC therapy. Adherence to treatment was defined as a score of 8 on MMAS-8 or as a PDC cutoff of ≥80%.
Results: The demographics, CHA2DS2-VASc scores, HAS-BLED scores, comorbidities, and combined medications were comparable between the 2 groups. In the standard care group, the proportion of patients with an MMAS-8 score of 8 decreased from 66.3% in the first month to 40% in the ninth month. Similarly, the proportion of patients with PDC≧80% dropped from 75% in the first month to 30% in the ninth month in this group. In the smart watch reminder group, the proportion of patients with an MMAS-8 score of 8 increased from 62.5% in the first month to 77.8% in the ninth month, while the proportion of patients with PDC≧80% remained >90% over the 9 months (p<0.005).
Conclusion: A smart watch that can send medication reminders can significantly improve adherence to OAC therapy in patients with AF.