Jared W. Magnani|Courtney Schlusser|Everlyne Kimani|Bruce L. Rollman|Michael K. Paasche?Orlow|Timothy Bickmore
The Atrial Fibrillation Health Literacy Information Technology System: Pilot Assessment
University of Pittsburgh|University of Pittsburgh|Northeastern University|University of Pittsburgh|Boston University|Northeastern University
atrial fibrillation af highly prevalent heart rhythm condition significant associated morbidity requires chronic treatment mobile health mhealth technologies potential enhance multiple aspects af care including education monitoring symptoms encouraging tracking medication adherence previously implemented tested relational agents improve outcomes chronic disease sought develop smartphonebased relational agent improving patientcentered outcomes afthe objective study pilot smartphonebased relational agent preparation randomized clinical trial atrial fibrillation health literacy information technology trial aflittwe developed relational agent use smartphone consistent prior approaches programmed relational agent computeranimated agent simulate facetoface conversation serve health counselor coach specific af relational agents dialogue content informed review literature focused patientcentered domains qualitative interviews patients af encompassed af education common symptoms adherence challenges patient activation established content accessible individuals limited health computer literacy relational agent content coordinated use smartphone alivecor kardia heart rate rhythm monitor participants n31 recruited convenience cohort ambulatory clinical sites instructed use relational agent kardia 30 days collected demographic social clinical characteristics conducted baseline 30day assessments healthrelated quality life hrqol atrial fibrillation effect quality life afeqt measure selfreported medication adherence morisky 8item medication adherence scale mmas8 patient activation patient activation measure pamparticipants mean age 68 sd 11 39 1231 women used relational agent average 178 sd 100 days mean number independent logins 196 sd 107 median 20 times 30 days mean number kardia uses 265 sd 59 participants using kardia af 143 sd 110 days afeqt scores improved significantly 645 sd 229 baseline 763 sd 194 units 30 days p01 observed marginal statistically significant improvement selfreported medication adherence baseline 73 sd 09 30 days 77 sd 05 p01 assessments acceptability identified participants found relational agent useful informative trustworthywe piloted 30day smartphonebased intervention combined relational agent dedicated content af alongside kardia heart rate rhythm monitoring pilot participants favorable improvements hrqol selfreported medication adherence well positive responses intervention data guide larger enhanced randomized trial implementing smartphone relational agent kardia monitor system