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Application of eHealth Tools in Anticoagulation Management After Cardiac Valve Replacement: Scoping Review Coupled
Ying Wu1,2, Xiaohui Wang2, Mengyao Zhou2
1Center for Moral Culture, Hunan Normal University, Changsha, China.
Insights
eHealth tools show promise for managing anticoagulation after cardiac valve replacement, improving patient satisfaction and therapeutic range. Further research is needed to confirm economic benefits and reduce complications.
Area of Science:
- Cardiology
- Medical Informatics
- Digital Health
Background:
- Effective anticoagulation management is crucial for preventing complications in cardiac valve replacement (CVR) patients.
- eHealth tools offer new avenues for managing long-term anticoagulation therapy.
- A comprehensive review of eHealth applications in post-CVR anticoagulation management is lacking.
Purpose of the Study:
- To summarize the current status and trends of eHealth tool utilization in post-CVR anticoagulation.
- To identify the benefits and challenges associated with these eHealth tools.
- To provide recommendations for future development in this field.
Main Methods:
- A scoping review following the Arksey and O'Malley framework.
- Searched five databases (PubMed, MEDLINE, Web of Science, CINAHL, Embase) up to March 1, 2023.
- Included studies on practical eHealth applications; excluded tool development mechanisms. Used VOSviewer for bibliometric analysis.
Main Results:
- 25 studies with 27,050 participants were included.
- eHealth tools (computer systems, EHRs, telemedicine, mobile apps) improved time in therapeutic range and life satisfaction.
- No significant impact on economic benefits or anticoagulation-related complications was observed. Machine learning and AI are emerging research areas.
Conclusions:
- eHealth tools hold potential for clinical application in post-CVR anticoagulation management and enhancing rehabilitation.
- High-quality research is required to evaluate the economic advantages and adverse event reduction potential of eHealth in long-term anticoagulation therapy.
Background:
Anticoagulation management can effectively prevent complications in patients undergoing cardiac valve replacement (CVR). The emergence of eHealth tools provides new prospects for the management of long-term anticoagulants. However, there is no comprehensive summary of the application of eHealth tools in anticoagulation management after CVR.
Objective:
Our objective is to clarify the current state, trends, benefits, and challenges of using eHealth tools in the anticoagulation management of patients after CVR and provide future directions and recommendations for development in this field.
Methods:
This scoping review follows the 5-step framework developed by Arksey and O'Malley. We searched 5 databases such as PubMed, MEDLINE, Web of Science, CINAHL, and Embase using keywords such as "eHealth," "anticoagulation," and "valve replacement." We included papers on the practical application of eHealth tools and excluded papers describing the underlying mechanisms for developing eHealth tools. The search time ranged from the database inception to March 1, 2023. The study findings were reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Additionally, VOSviewer (version 1.6.18) was used to construct visualization maps of countries, institutions, authors, and keywords to investigate the internal relations of included literature and to explore research hotspots and frontiers.
Results:
This study included 25 studies that fulfilled the criteria. There were 27,050 participants in total, with the sample size of the included studies ranging from 49 to 13,219. The eHealth tools mainly include computer-based support systems, electronic health records, telemedicine platforms, and mobile apps. Compared to traditional anticoagulation management, eHealth tools can improve time in therapeutic range and life satisfaction. However, there is no significant impact observed in terms of economic benefits and anticoagulation-related complications. Bibliometric analysis suggests the potential for increased collaboration and opportunities among countries and academic institutions. Italy had the widest cooperative relationships. Machine learning and artificial intelligence are the popular research directions in anticoagulation management.
Conclusions:
eHealth tools exhibit promise for clinical applications in anticoagulation management after CVR, with the potential to enhance postoperative rehabilitation. Further high-quality research is needed to explore the economic benefits of eHealth tools in long-term anticoagulant therapy and the potential to reduce the occurrence of adverse events.
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