Atrial Fibrillation
Conditions
Keywords
Telemedicine, Atrial Fibrillation, Primary care, Patient perception, Quality of life, Efficacy, Efficiency, Job Satisfaction, Patient safety, Mobile Applications
Brief summary
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world, with a large consumption of health resources. Telemedicine represents a new model of care, facilitating the individual approach to each patient and reducing costs and complications. This is an an open-label, randomized, multicenter, clinical trial aiming to analyze the use of telemedicine with AF patients in real clinical practice at primary care in terms of efficacy, efficiency, patient perception and professional satisfaction. The intervention will be based on the use of the Ti.Care app as the telemedicine support, in addition to the usual care. The follow-up will be carried out for 12 months.
Detailed description
Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world, with a prevalence between 2-4%. Given the increase in prevalence, its associated morbidity and mortality, and the large consumption of health resources there has been a need to adapt health care models. Telemedicine and the use of mobile devices represent a new model of care for chronic patients, facilitating the individual approach to each patient and reducing the disability associated with their chronic pathology. Objective: To analyze the use of telemedicine in patients with atrial fibrillation in real clinical practice in primary care trying in terms of efficacy (blood pressure control, incidence of ischemic stroke, incidence of bleeding), efficiency (number of visits to the clinic, hospitalizations, costs of care), patient perception (quality of life, therapeutic adherence, satisfaction with the mobile App) and professional satisfaction (satisfaction with the mobile App and benefits of its use in the clinic). Methods: The investigators propose to conduct an open-label, randomized, multicenter clinical trial. The intervention will be based on the use of the Ti.Care app as the telemedicine support, in addition to the usual care with their primary care physician (PCP). The control group will perform the usual follow-up with their PCP. The follow-up will be carried out for 12 months, and is proposed as an effective and cost-efficient improvement for the national health system and for the patient. Key words: Telemedicine, Mobile Applications, Atrial Fibrillation, Primary Health Care.
Interventions
DEVICEClinical monitoring using the Ti.Care app (https://ti.care/es)
Clinical monitoring using the Ti.Care app (https://ti.care/es)
OTHERUsual care
usual follow-up in primary care both arms
Sponsors
Universidad Miguel Hernandez de Elche
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients over 18 years of age diagnosed with AF. * Without difficulties in using the mobile App or patients with difficulties in using the mobile App but with good family or caregiver support, who understand its use.
Exclusion criteria
* Terminally ill patient. * Refusal to participate on the part of the patient * Difficulties in understanding the contents of the mobile App (cognitive impairment, dependence for activities of daily living, etc.) and no enabling family support
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Blood pressure control | one year | Measured with systolic and diastolic blood pressure |
| Incidence of ischemic stroke | one year | Measured as the number of recorded ischaemic stroke events in the study months. |
| Incidence of bleeding | one year | Number of bleeding events of any type recorded during follow-up. |
| Number of emergency visits | one year | Number of recorded visits to the emergency department in the study months. |
| Number of hospitalizations | one year | Number of hospital admissions for AF decompensation and its associated diseases during the study period. |
| Number of visits to primary care | one year | Number of registered visits to the primary care service in the study months. |
| Costs of care | one year | The indexes and prices of the Consejería de Sanidad for each type of consultation or hospitalisation and the established retail prices in the year of the study for medicines will be used. |
| Health-Related Quality Of Life | one year | Measured with EuroQol 5D questionnaire |
| Therapeutic adherence | one year | Measured with MMAS-8 Test (High adherence (8 or \> 8 points), medium (6 or 7 points) and low adherence (5 or \<5 points)) |
| Patient satisfaction with the mobile application | one year | Measured by the survey on satisfaction and perception of the use of new technologies in the field (designed for the study). Scoring: High satisfaction (4 or 5 points), medium (3 points), low satisfaction (1 or 2 points). |
| Professionals' satisfaction with the mobile application | one year | Measured by the survey on satisfaction and perception of the use of new technologies in the field (designed for the study). Scoring: High satisfaction (5-7 points), medium (3 or 4 points), low satisfaction (1 or 2 points). |
Contacts
Primary ContactAriana Jordá Baldó, Medicine
Backup ContactDomingo Orozco Beltrán, Medicine
Outcome results
None listed