Volume 19 Issue 5
May  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(5): 875-879
PAN Qiao-ling, ZHU Xiu-ying, RU Yuan-hui, ZHANG Pei, SHI Huo-shun, LI Ni, XU Guo-dong. A randomised controlled trial of warfarin anticoagulation after mechanical heart valve replacement via WeChat platform management[J]. Chinese Journal of General Practice, 2021, 19(5): 875-879. doi: 10.16766/j.cnki.issn.1674-4152.001939
Citation: PAN Qiao-ling, ZHU Xiu-ying, RU Yuan-hui, ZHANG Pei, SHI Huo-shun, LI Ni, XU Guo-dong. A randomised controlled trial of warfarin anticoagulation after mechanical heart valve replacement via WeChat platform management[J]. Chinese Journal of General Practice, 2021, 19(5): 875-879. doi: 10.16766/j.cnki.issn.1674-4152.001939
shu

A randomised controlled trial of warfarin anticoagulation after mechanical heart valve replacement via WeChat platform management

doi: 10.16766/j.cnki.issn.1674-4152.001939
  • 1.

    Nursing Department, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang 315211, China

Funds:

 LGD20H020001

  • Received Date: 2020-02-24
    Available Online: 2022-02-16
    Abstract
  •   Objective   A prospective, randomised, single-centre study was conducted to compare the efficacy and complications of warfarin anticoagulation in patients undergoing mechanical heart valve replacement postoperative management of patients was performed via WeChat platform or conventional methods.   Methods   According to the inclusion criteria, the patients in our hospital after undergoing mechanical valve replacement were randomly assigned to an experimental group (WeChat platform management group) and a control group (traditional management group). The control group received routine postoperative nursing guidance, whereas the experimental group received continuous nursing intervention via WeChat platform. Through regular outpatient follow-up, warfarin dosage was adjusted, and the general situation and complications of the two groups were recorded. The primary end point was international normalised ratio (INR) compliance rate, whereas the secondary end point included death, thromboembolism, bleeding and the number of, and anticoagulation-related emergency department visits.   Results   A total of 297 patients were enrolled in this study. No significant difference was observed between the two groups in terms of baseline characteristics, including gender, age and type of surgery. Compared with the control group, the experimental group had significantly improved INR compliance rate (75.48% vs. 59.38%, respectively; P < 0.001). No significant difference was found between the two groups in terms of major bleeding events (1.31% vs. 2.78%, respectively; P=0.368), thromboembolism events (1.31% vs. 0.69%, respectively; P=0.598) and deaths from any cause (0.65% vs. 1.39%, respectively; P=0.527). However, the incidence of mild bleeding events (17.6% vs. 30.6%, respectively; P=0.023) and the number of anticoagulation-related emergency department visits [0.86(0.00, 1.00) vs. 1.36(1.00, 2.00), respectively; P=0.031] in the experimental group were lower than those in the control group.   Conclusion   Compared with routine postoperative management, the application of WeChat platform to manage anticoagulation treatment of the patients after mechanical heart valve replacement can improve the INR compliance rate, reduced the incidence of mild bleeding events and the number of, anticoagulation-related emergency department visits.

     

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    • References(20)
  • [1]
    薛源, 李海红, 刘婷, 等. 基于多中心的非瓣膜性心房颤动患者抗凝治疗现状及影响因素分析[J]. 中国临床医学, 2018, 25(5): 728-732. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX201805010.htm
    [2]
    章小花. 国际标准化比值监测评估非瓣膜心房颤动患者华法林抗凝出血风险的研究[J]. 中华全科医学, 2015, 13(8): 1330-1331, 1384. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201508044.htm
    [3]
    PATEL R, CHANG T, GREYSEN S R, et al. Social media use in chronic disease: a systematic review and novel taxonomy[J]. Am J Med, 2015, 128(12): 1335-1350. doi: 10.1016/j.amjmed.2015.06.015
    [4]
    朱治辉, 张海波, 焦玉清, 等. "互联网+"背景下心脏机械瓣膜置换术后患者华法林抗凝治疗的研究进展[J]. 中国医药, 2018, 13(12): 1902-1905. doi: 10.3760/j.issn.1673-4777.2018.12.034
    [5]
    CHOW C K, REDFERN J, HILLIS G S, et al. Effect of Lifestyle-Focused Text messaging on risk factor modification in patients with coronary heart disease[J]. JAMA, 2015, 314(12): 1255-1263. doi: 10.1001/jama.2015.10945
    [6]
    WIDMER R J, ALLISON T G, LERMAN L O, et al. Digital health intervention as an adjunct to cardiac rehabilitation reduces cardiovascular risk factors and rehospitalizations[J]. J Cardiovasc Transl Res, 2015, 8(5): 283-292. doi: 10.1007/s12265-015-9629-1
    [7]
    张如新, 董真真, 马波, 等. 基于微信平台的同伴教育对肝癌患者介入术后心理、自我护理能力和生活质量的影响[J]. 中华全科医学, 2019, 17(11): 1951-1953. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201911044.htm
    [8]
    陈旭娥, 李季, 马婷, 等. 应用微信平台开展STD门诊艾滋病知识与行为健康教育的效果观察[J]. 浙江临床医学, 2018, 20(9): 1613-1614.
    [9]
    ROSENDAAL F R, CANNEGIETER S C, VAN DER MEER F J, et al. A method to determine the optimal intensity of oralanticoagulant therapy[J]. Thromb Haemost, 1993, 69(3): 236-239. doi: 10.1055/s-0038-1651587
    [10]
    王金凤, 邢莱丽, 魏小丽, 等. 临床药师指导下非瓣膜病房颤患者应用华法林抗凝治疗的疗效分析[J]. 河北医学, 2018, 24(8): 1404-1408. doi: 10.3969/j.issn.1006-6233.2018.08.047
    [11]
    李莲静, 刘健, 蒋卫民. 105例非瓣膜性心房颤动患者门诊抗凝治疗调查[J]. 中华全科医学, 2015, 13(12): 2014-2017. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201512041.htm
    [12]
    刘锐, 张魁, 董然. 华法林剂量预测模型与个体化治疗研究进展[J]. 中华实用诊断与治疗杂志, 2015, 29(8): 729-730. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD201508001.htm
    [13]
    许蔡艳, 曹莺, 严佳栋, 等. 临床药师用药指导下华法林的抗凝效果与安全性研究[J]. 安徽医药, 2018, 22(12): 2475-2478. doi: 10.3969/j.issn.1009-6469.2018.12.054
    [14]
    FENG S, LIANG Z, ZHANG R, et al. Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study[J]. Eur Arch Otorhinolaryngol, 2017, 274(3): 1477-1485. doi: 10.1007/s00405-016-4371-0
    [15]
    CAO Y, LIN S H, ZHU D, et al. WeChat public account use improves clinical control of cough-variant asthma: a randomized controlled trial[J]. Med Sci Monit, 2018, 24: 1524-1532. doi: 10.12659/MSM.907284
    [16]
    谭莲, 周蓓. 患者自我管理与专业机构管理在非瓣膜型心房颤动患者康复治疗中的应用效果比较[J]. 现代医药卫生, 2019, 35(16): 2520-2522. doi: 10.3969/j.issn.1009-5519.2019.16.030
    [17]
    SØLVIK U Ø, LØKKEBØ E, KRISTOFFERSEN A H, et al. Quality of warfarin therapy and quality of life are improved by self-management for two years[J]. Thromb Haemost, 2019, 19(10): 1632-1641. http://www.ncbi.nlm.nih.gov/pubmed/31370074
    [18]
    GRZYMALA-LUBANSKI B, SVENSSON P J, RENLUND H, et al. Warfarin treatment quality and prognosis in patients with mechanical heart valve prosthesis[J]. Heart, 2017, 103(3): 198-203. doi: 10.1136/heartjnl-2016-309585
    [19]
    DURÀES A R, BITAR Y D S L, FILHO J A L, et al. Rivaroxaban versus warfarin in patients with mechanical heart valve: rationale and design of the RIWA study[J]. Drugs R D, 2018, 18(4): 303-308. doi: 10.1007/s40268-018-0249-5
    [20]
    LOMBARDI N, CRESCIOLI G, BETTIOL A, et al. Italian emergency department visits and hospitalizations for outpatients' adverse drug events: 12-year active pharmacovigilance surveillance(the MEREAFaPS study)[J]. Front Pharmacol, 2020, 11: 412. doi: 10.3389/fphar.2020.00412
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