Nudging for Anticoagulation Adherence in Atrial Fibrillation

Condition(s) studied

Investigational drug(s) / intervention(s)

Nudge Intervention: Participants receive a multi-component nudge intervention including: an educational video on atrial fibrillation and stroke prevention; a personalized action plan linking pill-taking to a daily routine; a paper medication calendar with check-off grid and visual cues; tapered SMS reminders (weekly frequency declines from 3 to 1 over 8 weeks); weekly feedback messages; and a mid-point telephone call at week 4.

Study summary

The goal of this clinical trial is to learn if a nudging intervention (using text message reminders, a medication calendar, and action planning) can help people with atrial fibrillation take their blood-thinning medication (anticoagulants) as prescribed.

The main questions it aims to answer are:

Does the nudging intervention improve medication adherence compared to usual care?

How does the intervention affect patients' beliefs about their medication and the automaticity of pill-taking?

Is the intervention cost-effective?

Researchers will compare participants who receive the nudging intervention with those who receive usual care.

Participants will:

Watch a short educational video about atrial fibrillation and stroke prevention

Make a personal plan to take their medication at the same time each day (for example, after breakfast)

Receive text message reminders 1 to 3 times per week, with fewer messages over time

Get a medication calendar to track daily doses

Answer a few questionnaires at the start, at 8 weeks, and at 12 weeks

Eligibility

Primary outcome measure(s)

• Medication Adherence measured by the Medication Adherence Estimation and Differentiation Scale (MEDS) — Baseline (week 0), end of intervention (week 8), and follow-up (week 12)
  The MEDS is a 16-item, 5-point Likert scale (1=never to 5=always) assessing medication adherence across five dimensions: side effects, drug addiction, drug cost, lack of need/deliberate non-adherence, and unintentional non-adherence. Total scores range from 16 to 80, with higher scores indicating worse adherence.

Trial sites (1)

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