A Seoul National University Bundang Hospital (SNUBH) research team has developed a smartphone application aimed at enhancing medication adherence among atrial fibrillation (AF) patients taking oral anticoagulants.
Professors Choi Dong-ju (left) and Yoon Min-jae at SNUBH developed an app that improves anticoagulant adherence in atrial fibrillation patients. (Credit: SNUBH)
AF is an arrhythmia characterized by an irregular heartbeat originating in the atria. It can cause palpitations and chest discomfort and, in severe cases, dizziness and shortness of breath. Notably, AF significantly increases the risk of stroke due to blood clot formation, necessitating the use of oral anticoagulants for high-risk patients.
Traditionally, warfarin was the most commonly used oral anticoagulant, but in the 2010s, non-vitamin K antagonist oral anticoagulants (NOACs) emerged as a safer alternative.
However, these newer anticoagulants have a shorter half-life, meaning that missing even a single dose can significantly reduce their stroke prevention efficacy. Recent studies have indicated low adherence rates among AF patients, highlighting the need for effective solutions to improve medication compliance.
To address this issue, the team, led by Professors Choi Dong-ju and Yoon Min-jae from the Division of Cardiology at SNUBH, developed a smartphone app that provides medication reminders and guides patients to regularly monitor their blood pressure and pulse. Professor Lee Sung-young from the Department of Computer Science at Kyung Hee University collaborated on app development.
The app is integrated with a Bluetooth-enabled blood pressure monitor, automatically recording measurements and allowing users to track changes in their health status. This feature helps enhance patient engagement in health management and improve medication adherence.
The study assessed the app’s impact on 498 AF patients taking edoxaban, a NOAC.
The multicenter study was conducted across nine university hospitals in Korea, including SNUBH, Samsung Medical Center, Korea University Anam Hospital, Chungbuk National University Hospital, Keimyung University Dongsan Medical Center, Boramae Medical Center, Dongtan Sacred Heart Hospital, Gangnam Sacred Heart Hospital, and Bundang CHA Hospital.
Results showed that patients using the app were significantly more likely to maintain high medication adherence, with 73.9 percent of the app-user group (248 patients) sustaining over 95 percent adherence for six months, compared to 61 percent in the control group (250 patients) who did not use the app.
The app's effectiveness was particularly pronounced in elderly patients aged 65 and older. Among older patients using the app, 81.2 percent demonstrated high adherence rates, whereas only 58.9 percent of those in the control group maintained similar adherence. Given that elderly patients are more prone to forgetting their medications, the app’s reminder system and encouragement for blood pressure and heart rate monitoring likely played a crucial role in improving adherence.
“Our study demonstrates that a user-friendly smartphone app can greatly improve adherence to anticoagulant therapy and promote self-management among atrial fibrillation patients,” Professor Choi said. “We plan to further develop the app to support patients with other cardiovascular diseases and integrate it into clinical practice.”
The findings were published in the latest issue of the **[Journal of Medical Internet Research.](https://pubmed.ncbi.nlm.nih.gov/39570659/#full-view-affiliation-1)**