Feasibility Study of a Mobile Health Intervention for Older Adults on Oral Anticoagulation Therapy

Abstract

Background: Oral anticoagulation treatment (OAT) such as warfarin therapy is recommended for older adults with atrial fibrillation, heart failure, or who are at risk for venous thromboembolism. Despite its proven benefits, older adults report both dissatisfaction with OAT and reduced quality of life that can potentially lead to low adherence to OAT and decreased treatment efficacy. Objective: To test the feasibility of Mobile Applications for Seniors to enhance Safe anticoagulation therapy (MASS), a mobile-based health technology intervention designed to promote independence and self-care. Methods: This pilot study used a single-arm experimental pre–post design to test the feasibility of a 3-month intervention using MASS in 18 older adults (male: n = 14; White: n = 9; Hispanic: n = 7; Other: n = 2; M age = 67). MASS was available in English or Spanish. Participants completed surveys about their OAT knowledge, attitudes, quality of life with OAT, and adherence at baseline and at a 3-month follow-up. Satisfaction with the MASS intervention was also assessed at follow-up. Results: Anticoagulation knowledge significantly improved from baseline to follow-up (Mbase = 12.5 ± 5.51, Mfollow-up = 14.78 ± 3.93, p = .007). Other outcomes were not different, pre- and post-tests. Participants reported they were generally satisfied with MASS, its ease of use and its usefulness. Conclusion: The results showed use of MASS improved older adults’ knowledge of OAT. Using mHealth apps may enhance self-care among older adults with chronic conditions who are also taking oral anticoagulants.

Development and Testing of an Educational Mobile Application for Improving Knowledge Among Saudi Patients Receiving Warfarin

“…In line with the above trend, a previous American study developed an mHealth app for older patientson warfarin therapy to promote independence and self-care 26 . That study demonstrated, over a short observation period, a significant enhancement in patients' anticoagulation knowledge, but only using the OAK test.…”

“…A previous Chinese study with a larger sample size (N = 110) 44 developed an mApp specifically for patients with a sole warfarin indication (atrial fibrillation only), which in contrast to the previous mApp study 26 , demonstrated significant improvements in all outcomes including knowledge, adherence, anticoagulant satisfaction, and quality of life, besides a reduction in anxiety and depression. However, despite the similarity in the age groups (≥ 65 years) included in both previous mApp studies 26,42 , the larger sample size in the latter study could be a reason for the evident effect of the mApp intervention on PROs. In contrast to both studies, in our study, the age variable was normally distributed, and our patients were relatively younger.…”

“…However, despite a consensus that these additional services provide superior education about warfarin therapy, some patients still do not receive adequate education because of time constraints, lack of resources, or other patient variables that are beyond the control of healthcare providers (e.g., poor patient recall, age-related cognitive impairments, etc.) [23][24][25][26] .…”

“…Regarding anticoagulant therapy, very few published investigations have addressed the provision of specific mHealth technology for self-management and education in patients receiving warfarin therapy 25,26,42 . In Saudi Arabia, no analyses of anticoagulant educational interventions exist.…”

Climate change and the health of older people in Australia: A scoping review on the role of mobile applications (apps) in ameliorating impact

“…Data extraction was undertaken using a descriptive‐narrative approach . There were 35 selected articles . Tables were used to collate and summarise the data, and these data were shared within the research team.…”