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Abstract
Background: An educational-behavioral intervention has been shown to improve anticoagulation control with warfarin in atrial fibrillation (AF) patients, but widespread application may not be practical. The SAMe-TT2R2 score was formulated to identify the likelihood of achieving optimal time in therapeutic range (TTR).
Objectives: The authors conducted a randomized controlled trial to evaluate the impact of a SAMe-TT2R2 score-guided strategy for an educational-behavioral intervention, compared with usual care on patient’s anticoagulation control.
Methods: Anticoagulant-naive adult AF patients were randomized to a SAMe-TT2R2 score-guided strategy or usual care. In the SAMe-TT2R2 score-guided strategy group, scores 0 to 2 received usual care, >2 received educational-behavioral intervention plus usual care. All received warfarin targeting international normalized ratio 2.0 to 3.0. Primary outcome was TTR at 12 months. Secondary outcomes included TTR at 6 months, thromboembolic and bleeding events, major adverse cardiovascular events at 12 months, and change in AF knowledge at 6 and 12 months.
Results: A total of 320 patients (mean age 69.5 years; 48.8% female) were randomized to a SAMe-TT2R2 score-guided strategy plus usual care (n = 156) or usual care alone (n = 164). Mean CHA2DS2-VASc score and SAMe-TT2R2 score were 3.1 ± 1.4 and 3.3 ± 0.9, respectively. At 12 months, mean TTR was not significantly different between groups (41.0 [95% CI: 36.7-45.2] in the SAMe-TT2R2 score-guided strategy vs 40.2 [95% CI: 35.9-44.4] with usual care, and the difference between the 2 groups was 0.7 [95% CI: −5.2 to 6.6]). There were no significant differences in secondary outcomes.
Conclusions: SAMe-TT2R2 score-guided strategy for an educational-behavioral intervention, compared with usual care did not significantly improve outcomes over 12 months. (Thai Clinical Trials Registry identification number TCTR20180711003)
Objectives: The authors conducted a randomized controlled trial to evaluate the impact of a SAMe-TT2R2 score-guided strategy for an educational-behavioral intervention, compared with usual care on patient’s anticoagulation control.
Methods: Anticoagulant-naive adult AF patients were randomized to a SAMe-TT2R2 score-guided strategy or usual care. In the SAMe-TT2R2 score-guided strategy group, scores 0 to 2 received usual care, >2 received educational-behavioral intervention plus usual care. All received warfarin targeting international normalized ratio 2.0 to 3.0. Primary outcome was TTR at 12 months. Secondary outcomes included TTR at 6 months, thromboembolic and bleeding events, major adverse cardiovascular events at 12 months, and change in AF knowledge at 6 and 12 months.
Results: A total of 320 patients (mean age 69.5 years; 48.8% female) were randomized to a SAMe-TT2R2 score-guided strategy plus usual care (n = 156) or usual care alone (n = 164). Mean CHA2DS2-VASc score and SAMe-TT2R2 score were 3.1 ± 1.4 and 3.3 ± 0.9, respectively. At 12 months, mean TTR was not significantly different between groups (41.0 [95% CI: 36.7-45.2] in the SAMe-TT2R2 score-guided strategy vs 40.2 [95% CI: 35.9-44.4] with usual care, and the difference between the 2 groups was 0.7 [95% CI: −5.2 to 6.6]). There were no significant differences in secondary outcomes.
Conclusions: SAMe-TT2R2 score-guided strategy for an educational-behavioral intervention, compared with usual care did not significantly improve outcomes over 12 months. (Thai Clinical Trials Registry identification number TCTR20180711003)
| Original language | English |
|---|---|
| Journal | JACC: Asia |
| Early online date | 8 Oct 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 8 Oct 2024 |
Keywords
- anticoagulants
- atrial fibrillation
- education-behavioral
- SAMe-TT2R2 score
- warfarin
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Dive into the research topics of 'Impact of Educational Intervention on Anticoagulation Control Using SAMe-TT22R2 Score-Guided Strategy in Atrial Fibrillation'. Together they form a unique fingerprint.Projects
- 1 Finished
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TREATS-AF: Educational intervention vs usual care on anticoagulation therapy control based on a SAMe-TT2R2 score-guided strategy
Thomas, N. (Co-Investigator), Jowett, S. (Co-Investigator), Mathers, J. (Co-Investigator), Brocklehurst, P. (Co-Investigator), Shantsila, A. (Co-Investigator), Jolly, K. (Co-Investigator), Slade, A. (Co-Investigator), Windridge, D. (Co-Investigator), Gough, R. (Co-Investigator), Gough, R. (Co-Investigator), Gough, R. (Co-Investigator) & Lip, G. (Principal Investigator)
1/04/18 → 31/03/23
Project: Research Councils