| Atrial fibrillation is one of the main causes of stroke,heart failure,dementia,ischemic heart disease,sudden death,among which stroke is the most common and serious complication of atrial fibrillation.Oral anticoagulants can significantly reduce the risk of stroke in patients with atrial fibrillation,but a number of domestic and foreign studies have shown that the overall compliance of oral anticoagulants in patients with atrial fibrillation is poor,which leads to an increased risk of stroke in patients with atrial fibrillation.The intelligent medication management platform based on wechat mini program provides a new opportunity for improving the compliance of oral anticoagulant drugs in patients with atrial fibrillation.Objective:The objective of this study was to develop an intelligent management scheme for oral anticoagulants based on wechat mini program based on IMB model,technology acceptance model and the needs of patients with atrial fibrillation.Then complete the development,usability testing and effectiveness evaluation of Medi AF,an intelligent management platform for oral anticoagulants,and provide evidence-based evidence for improving medication compliance,anticoagulant knowledge level and quality of life of patients with atrial fibrillation.It also provides a new method for nursing staff to carry out health management for patients with atrial fibrillation.Methods:1.The module framework of the intelligent management platform for oral anticoagulants was constructed under the guidance of the IMB model through a questionnaire survey on the willingness and functional requirements of patients with oral anticoagulants,and the specific functional contents under each module framework were filled in according to the needs of patients with atrial fibrillation and optimized through expert consultation.Then form an intelligent management scheme of oral anticoagulant drugs based on wechat mini program.Later,the researchers collaborated with software development engineers to complete the research and development of Medi AF,an oral anticoagulant intelligent management platform.2.Usability test of Medi AF included user test and questionnaire survey.(1)User test: 10 patients with atrial fibrillation in the Department of Cardiology of a Grade-III Class A general hospital in Changchun were selected to complete the task list of wechat mini program test,and record whether the patients would perform the task,whether the execution was wrong and the reasons.(2)Questionnaire survey:conducted after the end of the user test method,using the system availability scale to measure the availability.3.Medi AF,an intelligent management platform for oral anticoagulants,was used as an intervention tool to evaluate its effectiveness: Patients with atrial fibrillation in the Department of Cardiology of a Grade-A general hospital in Changchun from July 2022 to October 2022 were selected as the study objects.The control group adopted the routine management method of oral anticoagulants in hospital,and the intervention group implemented Medi AF wechat mini program intervention.Medication compliance,anticoagulant knowledge,quality of life,anxiety and depression scale scores of patients in the two groups were collected at baseline and 1 month after intervention.In addition,medication punching,background messages and symptom records of patients in the intervention group were also collected through Medi AF background.Results:1.Based on IMB model,atrial fibrillation patients’ functional needs and technology acceptance model,formed an intelligent management scheme of oral anticoagulants based on wechat mini program,and completed the research and development of the wechat mini program of Medi AF,an intelligent management platform for oral anticoagulants,including four modules of medication reminder,health information,intelligent evaluation and my.Medication reminder module includes reminder,medication punch,medication record and other functions;Health information module includes atrial fibrillation,warfarin and new oral anticoagulants related knowledge;Intelligent assessment module includes stroke risk,bleeding risk,medication compliance,quality of life,etc.My module includes integral record,my message,symptom record and other functions.2.A total of 10 patients with atrial fibrillation were included in the usability test.During the user test,there were no execution errors in other tasks except tasks 2,5and 6.The results of the questionnaire showed that the average score of Medi AF was78.25 ± 6.02 points,indicating that Medi AF had good availability and could be accepted by patients.3.A total of 20 patients with atrial fibrillation with oral anticoagulants were included for effectiveness evaluation,10 in each of the two groups.The results are as follows:(1)Except for the type of complications,there was no significant difference in other demographic data of patients with atrial fibrillation(P > 0.05),which was comparable,and there was no statistical difference in baseline outcome indicators(P>0.05).(2)After intervention,the score of medication compliance was 6.18±0.51 points in the intervention group and 4.93±0.78 points in the control group.The score of anticoagulant knowledge in the intervention group was 14.50±1.43 points,and that in the control group was 10.70±2.50 points.The quality of life symptom dimension score of the intervention group was 80.42±6.82 points,and that of the control group was 69.58±10.03 points,the difference between the above outcome indicators was statistically significant(P < 0.05).There were no significant differences in the total score of quality of life,the other three dimensions,anxiety and depression scores between the two groups(P > 0.05).During the study period,10 patients clocking 209 times,the average clocking times was 20.90 ± 11.58 times,the clocking rate was69.67%.4 patients submitted a total of 15 messages through wechat mini program,and the background management gave timely replies.Conclusions:1.The intelligent management platform Medi AF for oral anticoagulants has a scientific framework,rich functions,authoritative content,concise and beautiful interface,strong operability,and good usability.2.Management of patients with atrial fibrillation based on Medi AF,an intelligent management platform for oral anticoagulants,can significantly improve patients’ compliance with oral anticoagulants,knowledge level of anticoagulants and symptoms of atrial fibrillation,and is an effective management tool. |
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