New treatment plan may increase cardiac survival and reduce stroke risk

Atrial fibrillation is a heart condition that affects two to four percent of the population. A new project will use digital tools to provide personalised support for patients to navigate their condition.

Treatment effectiveness, health care costs and quality of life outcomes for the two to four percent of Australians with the heart condition atrial fibrillation (AF), could be markedly improved under a new research project now underway in western Sydney.

Patients with atrial fibrillation (AF) will get better support and follow-up after they leave hospital, reducing their risk of repeat hospitalisation, stroke and congestive heart failure.

The project will use a successful engagement tool used in the USA to improve patient engagement and adherence to immunisation and medications, adapting it to provide personalised management and support to AF patients who have a wide variety of healthcare needs. The project will also customise the tool to suit the Australian health system.

The tool will use digital outreach methods to improve patients’ medical and lifestyle management, monitor symptoms and identify any potential complications of AF, so these can be addressed early.
 
The project is a collaboration between the University of Sydney’s Westmead Applied Research Centre (WARC), industry partner HMS, and the Australian Government-funded Digital Health Cooperative Research Centre (DHCRC).

Professor Tim Shaw is Director of Research at DHCRC and Professor of eHealth and Director of the Research in Implementation Science and eHealth Group (RISe) in the Faculty of Medicine and Health at the University of Sydney. He says when looking at international models, it is important to adapt to local conditions and find the most effective way to use them, before introducing them Australia-wide.

"This project will build evidence around how digital technologies can support patient care so that health systems can use this kind of program around Australia to better support, monitor and treat AF patients, lowering costs, improving health outcomes and reducing the rate of debilitating stroke," he says.
 
Project Lead, Professor Clara Chow is a Professor of Medicine and Academic Director of the University of Sydney’s Westmead Applied Research Centre (WARC) and cardiologist at Westmead Hospital.

"AF is increasingly common, a growing reason for health service presentation and a leading cause of stroke. A number of studies have also demonstrated AF patients miss out on important treatments that are indicated by guidelines," she says.

"The engagement tool uses multiple digital contact methods including SMS, emails and interactive voice response (IVR) technology which simulates a person-to-person call and reacts in real time to the responses patients provide, it is much more than just yes or no," Professor Chow says.
 
"These tools can help guide patients to appropriate follow-up visits, relevant health information and ask questions if issues arise. These systems could allow us to  develop a safe, scalable, cost-effective outreach program for AF patients, which down the track we can then translate to other chronic diseases as well."

One of the problems for patients with AF is the complexity of their medical therapy.

They might not think it’s important to keep taking their medication, or might be worried about side effects and missing these tablets make them more likely to have a stroke or heart failure, Professor Chow says.

Along with the digital reminders, the program also connects patients to their GP, and gives information about treatment options and lifestyle modifications.

"We want to gather evidence to show we can improve people’s self-management of health conditions, through digital health technologies," says Professor Chow.
 
"These changes might include making an appointment with their GP, taking their medication, giving up smoking, becoming more physically active, and eating a healthier diet."
 
The project being developed by Australian researchers could empower over 300,000 Australians who currently suffer from AF, to better manage their diagnosis.
 
It will also support clinicians by providing information to help treat AF patients more effectively.

 Declaration: The researchers declare no competing interests. Industry partner HMS, a healthcare systems provider, is partially funding the study through its contributions to the Digital Health CRC.  It is also providing the digital health platform. HMS is not involved in the research design or interpretation of the results. 


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