Smartphone-based mobile health impact on oral anticoagulation adherence, quality of life, and healthcare utilization in adult atrial fibrillation

Table 3 Impact of mobile health interventions on patient-reported outcomes

Ref.	Intervention/trial name	PRO domain and measurement tool	Follow-up	Key finding
Studies reporting significant improvements
Hsieh et al[35], 2021	Web-based integrated program	HRQoL: EQ-5D-3 L and EQ-VAS	6 months	Significantly higher scores in intervention group at 3 and 6 months (e.g., EQ-5D, β = 0.19, P < 0.001 at 6 months)
Hsieh et al[35], 2021	Web-based integrated program	Coping: Brief COPE scale	6 months	Significantly improved approach coping and reduced avoidance coping (P < 0.001)
Guo et al[31], 2017	mAFA pilot trial	HRQoL: EQ-5D-Y; satisfaction: ACTS	3 months	Significantly increased QoL, reduced anxiety/depression, and higher satisfaction (all P < 0.05)
Xu et al[36], 2024	Alfalfa app study	Satisfaction: Treatment satisfaction questionnaire for medication	3 months	Scores for effectiveness, side effects, convenience, and global satisfaction significantly higher (P < 0.001)
Studies reporting no significant difference
Caceres et al[34], 2021	iHEART study (ECG + texts)	HRQoL: AFEQT, SF-36, EQ-5D	6 months	No significant differences between groups. Clinically meaningful improvement observed in both arms
Magnani et al[37], 2025	Rural AF intervention	HRQoL: AFEQT, PROMIS-29	12 months	No significant differences in disease-specific or general quality of life scores

PRO: Patient-reported outcomes; HRQoL: Health-related quality of life; iHEART: Interactive heart health application for rhythm tracking; AF: Atrial fibrillation; AFEQT: Atrial fibrillation effect on quality-of-life questionnaire; SF-36: Short form health survey; EQ-5D: EuroQol 5-dimension; EQ-VAS: EuroQol visual analogue scale; COPE scale: Coping orientation to problems experienced scale; ACTS: Anti-clot treatment scale; PROMIS-29: Patient-reported outcomes measurement information system–29.