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https://tkuir.lib.tku.edu.tw/dspace/handle/987654321/121466
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| Title: | A Web-Based Integrated Management Program for Improving Medication Adherence and Quality of Life, and Reducing Readmission in Patients With Atrial Fibrillation: Randomized Controlled Trial |
| Authors: | Hsieh, Hui-Ling;Kao, Chi-Wen;Cheng, Shu-Meng;Chang, Yue-Cune |
| Keywords: | web-based program;atrial fibrillation;coping strategy;medication adherence;readmission;health-related quality of life |
| Date: | 2021-09-22 |
| Issue Date: | 2021-10-07 12:11:08 (UTC+8) |
| Publisher: | J M I R Publications, Inc. |
| Abstract: | Background: Atrial fibrillation (AF) is related to a variety of chronic diseases and life-threatening complications. It is estimated
that by 2050, there will be 72 million patients with AF in Asia, of which 2.9 million will have AF-associated stroke. AF has
become a major issue for health care systems.
Objective: We aimed to evaluate the effects of a web-based integrated management program on improving coping strategies,
medication adherence, and health-related quality of life (HRQoL) in patients with AF, and to detect the effect on decreasing
readmission events.
Methods: The parallel-group, single-blind, prospective randomized controlled trial recruited patients with AF from a medical
center in northern Taiwan and divided them randomly into intervention and control groups. Patients in the intervention group
received the web-based integrated management program, whereas those in the control group received usual care. The measurement
tools included the Brief Coping Orientation to Problems Experienced (COPE) scale, Medication Adherence Rating Scale (MARS),
the three-level version of the EuroQoL five-dimension self-report questionnaire (EQ-5D-3L), and readmission events 2 years
after initiating the intervention. Data were collected at 4 instances (baseline, 1 month, 3 months, and 6 months after initiating the
intervention), and analyzed with generalized estimating equations (GEEs).
Results: A total of 231 patients were recruited and allocated into an intervention (n=115) or control (n=116) group. The mean
age of participants was 73.08 (SD 11.71) years. Most participants were diagnosed with paroxysmal AF (171/231, 74%), and the
most frequent comorbidity was hypertension (162/231, 70.1%). Compared with the control group, the intervention group showed
significantly greater improvement in approach coping strategies, medication adherence, and HRQoL at 1, 3, and 6 months (all
P<.05). In addition, the intervention group showed significantly fewer readmission events within 2 years (OR 0.406, P=.03),
compared with the control group.
Conclusions: The web-based integrated management program can significantly improve patients' coping strategy and medication
adherence. Therefore, it can empower patients to |
| Relation: | Journal of Medical Internet Research 23(9), 30107 |
| DOI: | 10.2196/30107 |
| Appears in Collections: | [應用數學與數據科學學系] 期刊論文
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