ABSTRACT
Background : Adequate patient education is essential to enable patients to engage in shared decision-making (SDM) when deciding to stop or continue anticoagulation after 3 months of anticoagulation for venous thromboembolism (VTE). Aims : To evaluate the effect of an interactive, educational app on patients' level of satisfaction with information, perceived level of knowledge, decisional conflict and SDM when deciding on treatment duration after VTE. Methods : This randomized controlled trial in 1 academic and 3 general hospitals in The Netherlands included adult patients with VTE without malignancy or other indication for anticoagulation. Patients were randomized in a 1:1 ratio to receive the app (intervention group) in addition to the standard of care. The app contains information on VTE and anticoagulation on an interactive timeline, created for this study. In the week preceding the consultation when treatment duration is decided, patients were provided with daily videos using push notifications. Outcomes were assessed through online, self-reported questionnaires at baseline, 1-2 days before and 1 day after the consultation. Data were analyzed using t-tests and linear mixed models for repeated measurements. Results : The trial was terminated early as the inclusion rates dropped due to the COVID-19 pandemic. Data of 56 patients were analyzed (mean age 57±13;27% female). Satisfaction with received information was very heterogeneous and generally higher after the consultation (Figure 1). On a numeric rating scale from 0 to 10, patients who received the app were 0.86 points (95% CI 0.04 to 1.68;p 0.04) more satisfied with the provided information (Table 2). Patients who received the app experienced significantly less decisional conflict. No significant differences in satisfaction with knowledge, perceived knowledge and physician-reported SDM were observed. FIGURE 1 Change of satisfaction with received information over time stratified by intervention group. Measured at baseline, 1-2 days prior to consultation (“pre”) and 1 day after consultation (“post”). Colored lines indicate individual patients;blue thick line and confidence band indicate mean and 95% confidence interval Conclusions : An educational app about VTE and anticoagulation increases patients'satisfaction and reduces decisional conflict when deciding to stop or continue anticoagulation after initial treatment for VTE.