Smartphones to Improve Rivaroxaban ADHEREnce in Atrial Fibrillation

NCT ID: NCT02996435

Last Updated: 2018-10-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

139 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-21

Study Completion Date

2018-03-22

Brief Summary

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The primary purpose of this study is to evaluate the effectiveness of an intervention with a mobile adherence platform, compared to physician- or nurse-guided standard of care, to improve medication adherence to rivaroxaban in participants who have recently initiated treatment with rivaroxaban for stroke prevention in atrial fibrillation based on an assessment of the proportion of days covered (PDC) of rivaroxaban treatment.

Detailed Description

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Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Mobile Adherence Platform

Participant adherence will be monitored using a mobile application and platform which provides a real-time reminder that alerts the participant to take his or her medication. The application will also send an alert to the participant when a refill is needed based on calculated medication or pill supply. The intervention will focus only on daily adherence to rivaroxaban.

Group Type EXPERIMENTAL

Mobile Application Intervention

Intervention Type BEHAVIORAL

Mobile phone application that sends reminders and allows participants to self-manage their medication adherence. Monitoring of participant adherence from this tool will be performed by the central coordinating center, which will send notifications or contact the participant based on the adherence history in accordance with the study protocol.

Control: Standard of Care

Participants will receive physician- or nurse-guided standard of care for their rivaroxaban adherence. No drug will be administered as part of this study.

Group Type OTHER

No Intervention

Intervention Type OTHER

Participants will receive physician- or nurse-guided standard of care.

Interventions

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Mobile Application Intervention

Mobile phone application that sends reminders and allows participants to self-manage their medication adherence. Monitoring of participant adherence from this tool will be performed by the central coordinating center, which will send notifications or contact the participant based on the adherence history in accordance with the study protocol.

Intervention Type BEHAVIORAL

No Intervention

Participants will receive physician- or nurse-guided standard of care.

Intervention Type OTHER

Other Intervention Names

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Care4Today®

Eligibility Criteria

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Inclusion Criteria

* A history of atrial fibrillation
* Taking newly-prescribed rivaroxaban for atrial fibrillation for less than or equal to (\<=) 90 days or who are about to initiate therapy (with a prescription dated in the last 90 days)
* At least 1 of the 4 questions answered "yes" from the four-item Morisky Medication Adherence Scale (MMAS-4)
* Possession of a compatible smartphone with an active phone number, text and data plan. The smartphone must be in continued possession of the participant. It may not be a shared device and must exclusively remain in the possession of the participant during the study period. The smartphone must have an active cellular phone number and cellular data subscription. WiFi internet capability is not a substitute for an active cellular data plan
* Willing to have the adherence application installed on a smartphone and use it every day during the entire study period
* Must sign an informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study and is willing to authorize the study team to contact the participant's pharmacy for oral anticoagulation medication and refill data
* Willing to provide oral confirmation indicating that he/she has not previously used a medication adherence application
* Ability to read and understand English

Exclusion Criteria

* Anticipated inability to adhere to the mobile application (Care4Today) based on opinion of site Principal Investigator (PI)
* Anticipated rivaroxaban use less than (\<) 12 months based on clinical documentation or participant interview
* Prescribed rivaroxaban for indications other than atrial fibrillation (Prescriptions for concomitant conditions are allowed as long as 1 of the indications is atrial fibrillation)
* Current use of: specialized anticoagulation clinics for rivaroxaban medication management; specialized pharmacist-led adherence or refill monitoring; or enrollment in a medication adherence program even if that program is for medications other than rivaroxaban
* Current use of adherence tracking devices, hardware, smartphone or computer applications, including but not limited to smart pill bottles, pill timers, radiofrequency tagged medications or dispensers, mobile applications, or automated phone reminders. Pharmacy and health care plan automated refill reminders are permitted and are not exclusion. Pill organizers or containers that only compartmentalize a participant's medications based on days of the week are not exclusion. Pill organizers that remind participants when to take medicine with beeps or alerts are exclusion
* Cognitive, visual, hearing, voice, or motor impairment that would prevent completion of study procedures or use of mobile phone
* Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Scientific Affairs, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janssen Scientific Affairs, LLC Clinical Trial

Role: STUDY_DIRECTOR

Janssen Scientific Affairs, LLC

Locations

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Anchorage, Alaska, United States

Site Status

Los Angeles, California, United States

Site Status

Manhattan Beach, California, United States

Site Status

Oakland, California, United States

Site Status

Pasadena, California, United States

Site Status

Stanford, California, United States

Site Status

Ventura, California, United States

Site Status

Pensacola, Florida, United States

Site Status

Overland Park, Kansas, United States

Site Status

Lexington, Kentucky, United States

Site Status

Saint Joseph, Michigan, United States

Site Status

Reno, Nevada, United States

Site Status

Buffalo, New York, United States

Site Status

Jamaica, New York, United States

Site Status

Lake Success, New York, United States

Site Status

Mineola, New York, United States

Site Status

Saratoga Springs, New York, United States

Site Status

Canton, Ohio, United States

Site Status

Doylestown, Pennsylvania, United States

Site Status

Reading, Pennsylvania, United States

Site Status

Yardley, Pennsylvania, United States

Site Status

Memphis, Tennessee, United States

Site Status

Nashville, Tennessee, United States

Site Status

Austin, Texas, United States

Site Status

Bellevue, Washington, United States

Site Status

Countries

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United States

References

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Turakhia M, Sundaram V, Smith SN, Ding V, Michael Ho P, Kowey PR, Piccini JP, Foody J, Birmingham MC, Ianus J, Rajmane A, Mahaffey KW; smartADHERE Investigators. Efficacy of a centralized, blended electronic, and human intervention to improve direct oral anticoagulant adherence: Smartphones to improve rivaroxaban ADHEREnce in atrial fibrillation (SmartADHERE) a randomized clinical trial. Am Heart J. 2021 Jul;237:68-78. doi: 10.1016/j.ahj.2021.02.023. Epub 2021 Mar 4.

Reference Type DERIVED
PMID: 33676886 (View on PubMed)

Other Identifiers

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39039039AFL4010

Identifier Type: OTHER

Identifier Source: secondary_id

CR108260

Identifier Type: -

Identifier Source: org_study_id

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