心房細動患者の服薬アドヒアランスを向上させるモバイルアプリケーションの共同デザイン

Oral anticoagulation reduces stroke risk in atrial fibrillation, yet up to 30% of patients do not take their anticoagulation as prescribed. Mobile health applications incorporating behaviour change techniques may improve adherence. This study aimed to co-design a mobile health application to increase adherence to oral anticoagulation for atrial fibrillation.

The Person-Based Approach informed by Leventhal's Common Sense Self-Regulatory Model was used to involve participants with AF as co-designers of a medication adherence mHealth app. Participants recruited via British Heart Foundation existing contacts and social media advertising attended three workshops: 1) a patient storytelling session, 2) an interactive review of existing atrial fibrillation mobile health applications, and 3) pilot testing of the co-designed application. Data were collected using flipchart, post it notes and researcher field notes, with emphasis placed on direct quotations and storytelling. Eleven participants (7 males, aged 35-80 years) took part; and six were diagnosed with atrial fibrillation within the last five years with daily medication counts from 0-12. Eight (72%) participants were taking oral anticoagulants, and only two people used smartphones to manage their own health. The newly develop mobile application, MyAFNurse, featured a talking avatar and behaviour change techniques including a medication tracker, information about AF, advice on when and where to seek help, and a quiz to test knowledge.

The co-design approach to app design empowered AF patients, by incorporating their experiences and preferences. This fostered ownership over self-care and produced a tool grounded in users' real-world needs.