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Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+Heart+J+Plus 2021 ; 3 (ä): ä Nephropedia Template TP
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Rurality and atrial fibrillation: a pathway to virtual engagement and clinical trial recruitment in response to COVID-19 #MMPMID34151310
Magnani JW; Ferry D; Swabe G; Martin D; Chen X; Brooks MM; El Khoudary SR
Am Heart J Plus 2021[Mar]; 3 (ä): ä PMID34151310show ga
STUDY OBJECTIVE: To summarize trial adaptation from in-clinic to virtual design in response to the SARS-2 coronavirus-2 (COVID-19). DESIGN: A clinical trial of a mobile health intervention to improve chronic disease self-management for rural individuals with atrial fibrillation (AF). The trial has a 4-month intervention - accessible regardless of health or digital literacy - to enhance AF medication adherence and patient experience with 8- and 12-month assessments of sustainability. SETTING: Rural, western Pennsylvania. PARTICIPANTS: Rural individuals with AF receiving oral anticoagulation for stroke prevention. INTERVENTIONS: Enrolled participants underwent a telephone-based orientation, provided verbal consent, and were randomized using a digital platform. They received a smartphone with intervention or control applications and a curriculum on usage tailored for study arm. Participants received study assessments by mail with telephone-based administration and contact for the 12-month trial. MAIN OUTCOME MEASURES: Successful adaptation to virtual engagement and recruitment. RESULTS: The study enrolled 18 participants during in-clinic recruitment (January-March 2020). From 5/1/2020 to 5/6/2021 the study team enrolled 130 individuals (median age 72.4 years, range 40.8-92.2; 49.2% women, 63.1% without college degree, and 45.4% with limited health literacy. Retention of participants enrolled using virtual methods during the 4-month intervention phase is 92%. CONCLUSIONS: We report a virtual trial of a mobile health intervention for rural individuals with AF. Our successful implementation suggests promise for engaging geographically isolated rural individuals, potential to enhance digital health access, and advance rural health equity.