A Mobile Application for Anticoagulation Management in Patients After Heart Valve Replacement: A Usability Study

Xia Yuan,1,2,* Shenmin Wan,1,2,* Wenshuo Wang,2,3 Yihong Chen,1,2 Ying Lin1 1Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Shanghai Heart Valve Engineering Technology Research Center, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yihong Chen; Ying Lin, Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel +86 21-64041990, Email [email protected]; [email protected]: Individualized anticoagulation therapy is a major challenge for patients after heart valve replacement. Mobile applications assisted by Artificial intelligence (AI) have great potential to meet the individual needs of patients. The study aimed to develop an AI technology-assisted mobile application (app) for anticoagulation management, understand patients’ acceptance of such applications, and determine its feasibility.Methods: After using the mobile application for anticoagulation management for 2 weeks, patients, doctors, and nurses rated its usability using the System Usability Scale (SUS). Additionally, semi-structured interviews were conducted with some patients, doctors, and nurses to gain insights about their thoughts and suggestions regarding the procedure.Results: The study comprised 80 participants, including 38 patients, 18 doctors, and 24 nurses. The average SUS score for patients was 82.37± 5.45; for doctors, it was 84.17± 5.82; and for nurses, it was 81.88± 6.44. This means the patients, physicians, and nurses rated the app highly usable. Semi-structured interviews were conducted on the app’s usability with 18 participants (six nurses, three physicians, and nine patients). The interview results revealed that patients found the application of anticoagulation management simple and convenient, with high expectations for a precise dosage recommendation of anticoagulant drugs. Some patients expressed concerns regarding personal information security. Both doctors and nurses believed that elderly patients needed assistance from young family members to use the app and that it could improve patients’ anticoagulant self-management ability. Some nurses also mentioned that the use of the app brought great convenience for transitional care.Conclusion: This study confirmed the feasibility of using an AI technology-assisted mobile application for anticoagulation management in patients after heart valve replacement. To further develop this application, challenges lie in continuously improving the accuracy of recommended drug doses, obtaining family support, and ensuring information security.Keywords: anticoagulation management, artificial intelligence (AI) technology, mobile application, heart valve replacement, warfarin