Development and evaluation of the effectiveness of mobile individual atrial fibrillation management (m-bafy) program
E Simsek, A Ay, S Ozer, O YilmazAbstract
Background
Atrial fibrillation (AF), the most common cardiac arrhythmia worldwide, is estimated to affect 2-4% of adults globally. As the increasing number of atrial fibrillation cases leads to adverse clinical outcomes and reduced quality of life, effective management is essential, particularly to prevent disease exacerbations and hospitalizations. Increasing disease awareness and encouraging active participation in individual management activities are gaining importance and priority. Mobile health applications can not only remind patients of the information provided and integrate it into daily life, but also provide encouragement and close monitoring. Mobile applications can provide significant support in the holistic management of chronic diseases such as atrial fibrillation.
Aim
The aim of this study was to develop a mobile individual atrial fibrillation management (m-BAFY) program and evaluate its impact on symptom severity, medication adherence, self-care agency, and quality of life.
Methods
The study was conducted as a randomized controlled experimental trial in the arrhythmia-pacemaker outpatient clinic of a university hospital between June 2024 and April 2025. The sample consisted of 45 patients with AF who met the inclusion criteria in the intervention group and 45 patients in the control group. Data were collected using the Patient Identification Form, EHRA AF Symptom Classification, University of Toronto Atrial Fibrillation Severity Scale, Medication Adherence Reporting Scale, Self-Care Ability Scale, and the Impact of Atrial Fibrillation on Quality of Life Questionnaire. The m-BAFY program was installed on the phones of patients in the intervention group. They were asked to use the m-BAFY program for three months and to complete a symptom diary at least every two weeks. Patients in the control group received standard care administered in the outpatient clinic. Data were collected face-to-face at the end of months 0, 1, and 3. The obtained data were analyzed using appropriate methods. Statistical significance level was accepted as p˂0.05.
Results
Patients in the intervention and control groups were found to be homogeneously distributed in terms of sociodemographic and disease characteristics. While the group x time interaction did not produce a significant difference in the mean AF severity scores of participants in the intervention and control groups (p=0.053), the group x time interaction was found to be significant for AF burden (p=0.036), symptom severity (p=0.004), medication adherence (p=0.005), self-care agency (p<0.001), and quality of life (p<0.001).
Conclusion
It was concluded that the developed m-BAFY program reduces the symptom severity of patients with atrial fibrillation, increases medication compliance, self-care agency, and quality of life, and can be included in the care process.