The Effects of Implementing a Mobile Health–Technology Supported Pathway on Atrial Fibrillation–Related Adverse Events Among Patients With Multimorbidity

作者：Yuan Yao, Yutao Guo, Gregory Y.H. Lip, mAF-App II Trial investigators, Yutao Guo, Gregory Y.H. Lip, Deirdre A. Lane, Yundai Chen, Liming Wang, Jens Eckstein, G. Neil Thomas, Tong Liu, Mei Feng, Xuejun Liu, Xiaoming Li, Zhaoliang Shan, Shi Xiangming, Wei Zhang, Yunli Xing, Jing Wen, Fan Wu, Sitong Yang, Xiaoqing Jin, Bo Yang, Xiaojuan Bai, Yuting Jiang, Yangxia Liu, Yingying Song, Zhongju Tan, Yang Li, Tianzhu Luan, Chun-Feng Niu, Lili Zhang, Shuyan Li, Zulu Wang, Bing Xv, Li Liu, Yuanzhe Jin, Yunlong Xia, Xiaohong Chen, Fang Wu, Lina Zhong, Yihong Sun, Shujie Jia, Jing Li, Nan Li, Shijun Li, Huixia Liu, Rong Li, Fan Liu, GE Qing-feng, Tianyun Guan, Yuan Wen, Xin Li, Yan Ren, Xiaoping Chen, Ronghua Chen, Yun Shi, Yulan Zhao, Haili Shi, Yujie Zhao, Quanchun Wang, Weidong Sun, Lin Wei, Esther W. Chan, Guangliang Shan, Yao Chen, Wei Zong, Dandi Chen, Han Xiang, Anding Xu, Xiaohan Fan, Ziqiang Yu, Xiang Gu, Fulin Ge · 发表于：JAMA Network Open · 年份：2021 · DOI：10.1001/jamanetworkopen.2021.40071 · 被引用次数：67 · 研究领域：Atrial Fibrillation Management and Outcomes、Chronic Disease Management Strategies、Heart Failure Treatment and Management

Importance: The Mobile Health Technology for Improved Screening and Optimized Integrated Care in Atrial Fibrillation (mAFA-II) trial is a prospective cluster randomized trial that found a significant reduction in the composite clinical outcome of stroke or thromboembolism, all-cause death, and rehospitalization among patients with atrial fibrillation (AF) who used a mobile health (mHealth) technology that implemented the Atrial Fibrillation Better Care (ABC) pathway (ie, A, anticoagulation/avoid stroke; B, better symptom control; and C, cardiovascular disease and comorbidity management) compared with those receiving usual care. Multimorbidity (defined as ≥2 chronic long-term conditions) is common in older patients with AF, but the impact of integrated or holistic care (based on the ABC pathway) on clinical outcomes in this population is uncertain. Objective: To evaluate whether implementation of the integrated ABC pathway, supported by mHealth technology, would reduce AF-related adverse events in patients with multimorbidity. Design, Setting, and Participants: This prespecified ancillary analysis of data from the extended follow-up of the mAFA II trial was conducted between June 2018 and April 2021. Adult patients with AF were included in the analysis if they had at least 2 comorbidities. Participants were enrolled across 40 centers in China. Intervention: Integrated care supported by mHealth technology (mAFA intervention) vs usual care. Main Outcomes and Measures: The main o...