NUR 01.6 - Social App to Improve Warfarin Therapy in post-MHVR Chinese patients: A Randomized Controlled Trial

Background: Poor anticoagulation quality was a major problem among warfarin-treated patients, which called for innovative and effective methods to improve it.

Aims: To investigate whether social app could be used to reduce warfarin-associated adverse events among post-MHVR Chinese patients.

Methods: 735 warfarin-treated patients (aged 50.8 ± 9.6 years, 59.9% female) were enrolled and randomized to a social app care group (warfarin therapy was guided by experienced clinicians via a social app) or a routine care group (warfarin therapy was managed through traditional in-office visits) at a 1:1 ratio. Ending points (bleeding and thrombotic events) were recorded during an 18-months follow-up period.

Results: A total of 718 patients were included in analysis. 57 patients of them suffered warfarin-associated adverse events, including 30 major bleedings and 27 thrombotic events. The time in the therapeutic range (TTR, Rosendaal Method) in the social app group was 71.5%, which was significantly better than 52.6% in the routine care group (difference: 18.8%, 95% CI: 16.8-20.8). Compared with the patients from the social app group, patients under routine care experienced more bleeding (hazard ratio (HR): 2.31, 95% CI: 1.13-4.72). The social app care group had lower variation (0.55 vs 0.70) in the international normalized ratio (INR) values and fewer incidents of extremely high INR (e.g., INR>5.0, 0.87% vs 3.42%) than the routine care group.

Conclusion(s): Social app management could significantly improve warfarin control and was associated with a reduction in bleeding risk. (Clinical Trials.gov; NCT03264937)