Impact of Educational Intervention on Anticoagulation Control Using SAMe-TT<inf>2</inf>2R<inf>2</inf> Score-Guided Strategy in Atrial Fibrillation
Issued Date
2024-01-01
Resource Type
eISSN
27723747
Scopus ID
2-s2.0-85207366124
Journal Title
JACC: Asia
Rights Holder(s)
SCOPUS
Bibliographic Citation
JACC: Asia (2024)
Suggested Citation
Phrommintikul A., Nathisuwan S., Wongcharoen W., Krittayaphong R., Gunaparn S., Wongthanee A., Mathers J., Jowett S., Jolly K., Lane D.A., Thomas G.N., Lip G.Y.H., Thomas G.N., Krittiyaphong R., Slinn G., Sehmi S., Lane D., Jowett S., Permsuwan U., Jiraporncharoen W., Angkurawaranon C., Slade A., Mehta S., Winkle N., Songmuang S.B., Kunjara Na Ayudhya R., Yenn-Jiang L., Thongsri T., Liabsuetrakul T., Preedalikit K., Chantrarat T., Wongtheptien W., Wattanasombat S., Kaewdam J., Mananusorn N., Sawatna W., Chotayaporn T., Lertthanaphol K., Pothongsunun B., Chandee J., Prasit T., Ruttanapornnukul C., Sripattanatrakul K., Cheingyothakul V., Prasertwitayakij N., Niwatananun K., Silavanich V., Nimworapan M., Somsap P., Pornwisrtsirikul T., Daoram P., Srisongmuang C., Bureekam N., Intharangsri S., Kawila C., Winigkul A., Kaolawanich Y., Sarapakdi A., Pienpattapong U., Chaiphet O., Sookananchai B., Niyomsiriwanich P., Wiwatworapan W., Sapoo U., Kowitphattana S., Sae-Ueng K., Jirapermpun A., Senthong V., Onsanit S., Jantharuechai S., Tipboonchu W. Impact of Educational Intervention on Anticoagulation Control Using SAMe-TT<inf>2</inf>2R<inf>2</inf> Score-Guided Strategy in Atrial Fibrillation. JACC: Asia (2024). doi:10.1016/j.jacasi.2024.08.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101855
Title
Impact of Educational Intervention on Anticoagulation Control Using SAMe-TT<inf>2</inf>2R<inf>2</inf> Score-Guided Strategy in Atrial Fibrillation
Author(s)
Phrommintikul A.
Nathisuwan S.
Wongcharoen W.
Krittayaphong R.
Gunaparn S.
Wongthanee A.
Mathers J.
Jowett S.
Jolly K.
Lane D.A.
Thomas G.N.
Lip G.Y.H.
Thomas G.N.
Krittiyaphong R.
Slinn G.
Sehmi S.
Lane D.
Jowett S.
Permsuwan U.
Jiraporncharoen W.
Angkurawaranon C.
Slade A.
Mehta S.
Winkle N.
Songmuang S.B.
Kunjara Na Ayudhya R.
Yenn-Jiang L.
Thongsri T.
Liabsuetrakul T.
Preedalikit K.
Chantrarat T.
Wongtheptien W.
Wattanasombat S.
Kaewdam J.
Mananusorn N.
Sawatna W.
Chotayaporn T.
Lertthanaphol K.
Pothongsunun B.
Chandee J.
Prasit T.
Ruttanapornnukul C.
Sripattanatrakul K.
Cheingyothakul V.
Prasertwitayakij N.
Niwatananun K.
Silavanich V.
Nimworapan M.
Somsap P.
Pornwisrtsirikul T.
Daoram P.
Srisongmuang C.
Bureekam N.
Intharangsri S.
Kawila C.
Winigkul A.
Kaolawanich Y.
Sarapakdi A.
Pienpattapong U.
Chaiphet O.
Sookananchai B.
Niyomsiriwanich P.
Wiwatworapan W.
Sapoo U.
Kowitphattana S.
Sae-Ueng K.
Jirapermpun A.
Senthong V.
Onsanit S.
Jantharuechai S.
Tipboonchu W.
Nathisuwan S.
Wongcharoen W.
Krittayaphong R.
Gunaparn S.
Wongthanee A.
Mathers J.
Jowett S.
Jolly K.
Lane D.A.
Thomas G.N.
Lip G.Y.H.
Thomas G.N.
Krittiyaphong R.
Slinn G.
Sehmi S.
Lane D.
Jowett S.
Permsuwan U.
Jiraporncharoen W.
Angkurawaranon C.
Slade A.
Mehta S.
Winkle N.
Songmuang S.B.
Kunjara Na Ayudhya R.
Yenn-Jiang L.
Thongsri T.
Liabsuetrakul T.
Preedalikit K.
Chantrarat T.
Wongtheptien W.
Wattanasombat S.
Kaewdam J.
Mananusorn N.
Sawatna W.
Chotayaporn T.
Lertthanaphol K.
Pothongsunun B.
Chandee J.
Prasit T.
Ruttanapornnukul C.
Sripattanatrakul K.
Cheingyothakul V.
Prasertwitayakij N.
Niwatananun K.
Silavanich V.
Nimworapan M.
Somsap P.
Pornwisrtsirikul T.
Daoram P.
Srisongmuang C.
Bureekam N.
Intharangsri S.
Kawila C.
Winigkul A.
Kaolawanich Y.
Sarapakdi A.
Pienpattapong U.
Chaiphet O.
Sookananchai B.
Niyomsiriwanich P.
Wiwatworapan W.
Sapoo U.
Kowitphattana S.
Sae-Ueng K.
Jirapermpun A.
Senthong V.
Onsanit S.
Jantharuechai S.
Tipboonchu W.
Corresponding Author(s)
Other Contributor(s)
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)