Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation

Guo, Yutao; Lane, Deirdre A.; Wang, Limin; Zhang, Hui; Wang, Hao; Zhang, Wei; Wen, Jing; Xing, Yunli; Wu, Fang; Xia, Yunlong; Liu, Tong; Wu, Fan; Liang, Zhaoguang; Liu, Fan; Zhao, Yujie; Li, Rong; Li, Xin; Zhang, Lili; Guo, Jun; Burnside, Girvan; Chen, Yundai; Lip, Gregory Y.H.; investigators, mAF-App Ii Trial

doi:10.1016/j.jacc.2020.01.052

Cited by 225 publications

(160 citation statements)

References 28 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…In the mAFA-II trial, we previously reported the short term outcomes (mean follow-up of 262 days) associated with mobile health management based on the Atrial fibrillation Better Care pathway, with a significant reduction in the composite outcomes, that was largely driven by hospitalisations [7] . In the present analysis of those (long term) mAFA participants with ≥ 1 year use/followup, there were maintained reductions in the composite outcome and hospitalization using mAFA trial intervention.…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that photoplethysmography based general-population atrial fibrillation screening approach was feasible, whereby 0.23% with “suspected” atrial fibrillation from a screened population of 246,541 received a notification of suspected atrial fibrillation, of which 87% were confirmed as atrial fibrillation, and 80% of high-risk patients were subsequently anticoagulated [6] . Short term outcomes (mean followup 262 days) of such identified atrial fibrillation patients randomized into the mAFA-II (mobile Atrial Fibrillation App) cluster randomized trial using mobile health (mHealth) based integrated care management found a significant reduction in the composite outcome of ‘ischaemic stroke/systemic thromboembolism, death, and rehospitalization’, compared to usual care [7] . However, the long-term adherence/persistence of mobile health technology use and the impact on clinical outcomes, remains uncertain although the approach has been increasingly proposed for chronic disease management.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort

Guo

Shi

et al. 2020

European Journal of Internal Medicine

Self Cite

View full text Add to dashboard Cite

Highlights Amongst AF patients with long term use (≥1 year) of mHealth technology for optimising stroke prevention, symptom control and comorbidity management, there was a reduced risk for the composite outcome of 'ischaemic stroke/systemic thromboembolism, death, and rehospitalization’ in patients using App-based management based on the ABC (Atrial fibrillation Better Care) pathway. Rates of clinical outcomes (thromboembolism, bleeding events, recurrent atrial fibrillation and its symptoms, heart failure, and rehospitalization) were lower in patients allocated to mAF App intervention, compared with usual care. Over 70% of patients using the mAF App had adherence of approximately 70%, with the overall persistence of mAFA use being 91.7%.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort

Guo

Shi

et al. 2020

European Journal of Internal Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…disease-specific educational applications, monitoring technology). 10 , 11 These applications aim to encourage integrated AF management whether it is by supporting decision-making in the treatment team or empowering patients to monitor their vital parameters and self-manage their condition.…”

Section: The Telecheck-af Approachmentioning

confidence: 99%

Implementation of an on-demand app-based heart rate and rhythm monitoring infrastructure for the management of atrial fibrillation through teleconsultation: TeleCheck-AF

et al. 2020

View full text Add to dashboard Cite

During the coronavirus 2019 (COVID-19) pandemic, outpatient visits in the atrial fibrillation (AF) clinic of the Maastricht University Medical Centre (MUMC+) were transferred into teleconsultations. The aim was to develop anon-demand app-based heart rate and rhythm monitoring infrastructure to allow appropriatmanagement of AF through teleconsultation. In line with the fundamental aspects of integrated care, including actively involving patients in the care process and providing comprehensive care by a multidisciplinary team, we implemented a mobile health (mHealth) intervention to support teleconsultations with AF patients: TeleCheck-AF. The TeleCheck-AF approach guarantees the continuity of comprehensive AF management and supports integrated care through teleconsultation during COVID-19. It incorporates three important components: (i) a structured teleconsultation (‘Tele’), (ii) a CE-marked app-based on-demand heart rate and rhythm monitoring infrastructure (‘Check’), and (iii) comprehensive AF management (‘AF’). In this article, we describe the components and implementation of the TeleCheck-AF approach in an integrated and specialized AF-clinic through teleconsultation. The TeleCheck-AF approach is currently implemented in numerous European centres during COVID-19.

show abstract

“…This aims to support and guide the patient through the care process (eg, patient education and instruction) as well as the treatment team (smart technology to support decision making). [35] In fact, such technology solutions should support integrated care in terms of actively involving patients in their care process, collaboration within multidisciplinary teams, and provide guidance in the complex (shared) treatment decisions and coordination of care.…”

Section: Clinical Implementation Of Teleconsultation and Mhealth Somentioning

confidence: 99%

On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

Hermans¹,

Velden²,

Gawałko

et al. 2020

Clinical Cardiology

View full text Add to dashboard Cite

Background: Although novel teleconsultation solutions can deliver remote situations that are relatively similar to face-to-face interaction, remote assessment of heart rate and rhythm as well as risk factors remains challenging in patients with atrial fibrillation (AF). Hypothesis. Mobile health (mHealth) solutions can support remote AF management. Methods: Herein, we discuss available mHealth tools and strategies on how to incorporate the remote assessment of heart rate, rhythm and risk factors to allow comprehensive AF management through teleconsultation. Results: Particularly, in the light of the coronavirus disease 2019 (COVID-19) pandemic, there is decreased capacity to see patients in the outpatient clinic and mHealth has become an important component of many AF outpatient clinics. Several validated mHealth solutions are available for remote heart rate and rhythm monitoring as well as for risk factor assessment. mHealth technologies can be used for (semi-)continuous longitudinal monitoring or for short-term on-demand monitoring, dependent on the respective requirements and clinical scenarios. As a possible solution to improve remote AF care through teleconsultation, we introduce the on-demand TeleCheck-AF mHealth approach that allows remote app-based assessment of heart rate and rhythm around teleconsultations, which has been developed and implemented during the COVID-19 pandemic in Europe. Conclusion: Large scale international mHealth projects, such as TeleCheck-AF, will provide insight into the additional value and potential limitations of mHealth strategies to remotely manage AF patients. Such mHealth infrastructures may be well suited within an integrated AF-clinic, which may require redesign of practice and reform of health care systems. How to cite this article: Hermans ANL, van der Velden RMJ, Gawalko M, et al. On-demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation.

show abstract

Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation

Cited by 225 publications

References 28 publications

Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort

Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort

Implementation of an on-demand app-based heart rate and rhythm monitoring infrastructure for the management of atrial fibrillation through teleconsultation: TeleCheck-AF

On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

Contact Info

Product

Resources

About