Evaluation of the effectiveness of a mobile application on the adherence of patients with atrial fibrillation

Background
To date, no research on the adherence of patients with atrial fibrillation (AF) within the territory of Kazakhstan and Central Asia has been conducted.

Objectives
The study aimed to investigate the effect of a mobile application on adherence in patients diagnosed with AF and treated in outpatient clinics. In addition, the reliability of a structured scale for assessing adherence in patients with atrial fibrillation was also validated.

Material and methods
A prospective one-centre study was conducted on 599 patients diagnosed with AF at the City Cardiology Centre (Almaty, Kazakhstan). Patients were sub-divided into control (CG) and intervention (IG) groups. Patients in the IG group used the MyTherapy mobile app. Treatment adherence was assessed using the 14-item Lebanese Drug Adherence Scale (LMAS-14). Data was collected before starting therapy (T1) and 3 months (T2), 6 months (T3) and 12 months (T4) after the start of treatment.

Results
In the T1 period, the adherence of patients in the CG and IG groups was average (p = 0.547). After 3 months (T2), adherence of participants in the IG group (39.1 ± 1.3) was significantly higher than in the CG group (p ≤ 0.05). In the T3 period, patients of the IG group had a high adherence equal to 38.3 ± 1.6 (p ≤ 0.05). After 12 months (T4), the respondents in the IG group retained high adherence rates equal to 38.9 ± 3.2 (p = 0.001). An estimate of the readmission rate within 12 months shows relatively low rates in the IG group (9.8%).

Conclusions
The results of the study showed the effectiveness of using the MyTherapy mobile app for increasing adherence in patients with AF. In addition, the use of the LMAS-14 facilitated and optimised the assessment of the level of adherence in patients with AF.