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Life sciences · Journal article
Frontiers in Cardiovascular Medicine · June 30, 2026
Encouraging direction, but not yet definitive.
This single-centre RCT of an Internet Plus Nursing mode telehealth intervention in 122 warfarin-treated atrial fibrillation patients found significantly higher INR compliance, monitoring rates, medication adherence, and health knowledge scores in the intervention group compared to usual care over 6 months. However, no statistically significant difference in clinical complication or readmission rates was observed, indicating improvement in process measures but not yet in hard clinical outcomes.
Single-centre, randomized controlled trial. Patients on long-term oral warfarin enrolled from the Department of Cardiology, Jiaxing Second Hospital, Zhejiang Province, China, between January 2024 and December 2024. All participants provided written informed consent.. Intervention: Internet Plus Nursing mode (INM) telehealth intervention delivered via WeChat and cloud-based platforms, providing real-time health education and monitoring in addition to routine education manual.. Compared with: Usual care: routine education manual provided at discharge.. n = 122. Jiaxing Second Hospital, Zhejiang Province, China..
INR compliance at 10 days: 98.33% (INM) vs. 86.54% (usual care), P = 0.045 INR compliance at 1 month: 86.67% (INM) vs. 57.69% (usual care), P = 0.015 Medication adherence: 88.33% (INM) vs. 48.08% (usual care), P < 0.001
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The results suggest that Internet Plus Nursing mode can improve intermediate process measures (medication adherence, INR compliance, patient knowledge) in warfarin management, which are important for anticoagulation control. However, the lack of difference in clinical complications or readmission rates over 6 months means the intervention's impact on hard clinical outcomes remains uncertain; clinicians should view this as promising but not yet conclusive evidence of clinical benefit.
A single-centre RCT with adequate sample size showing improvements in intermediate outcomes (INR compliance, medication adherence, health knowledge) but no difference in hard clinical endpoints (complications, readmission); results suggest benefit but require replication in larger, multicentre populations.
As stated by the source record.
Quoted from the source exactly as published.
The results suggest that Internet Plus Nursing mode can improve intermediate process measures (medication adherence, INR compliance, patient knowledge) in warfarin management, which are important for anticoagulation control. However, the lack of difference in clinical complications or readmission rates over 6 months means the intervention's impact on hard clinical outcomes remains uncertain; clinicians should view this as promising but not yet conclusive evidence of clinical benefit.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objective To explore the application effect of the Internet Plus Nursing mode (INM) on managing patients taking oral warfarin in a randomized controlled trial with a 6-month follow-up period. Methods A total of 122 patients on long-term oral warfarin were selected from the Department of Cardiology, Jiaxing Second Hospital, Zhejiang Province, from January 2024 to December 2024. Patients were randomly divided into an INM group ( n = 61) and a usual care group ( n = 61) using a randomized numerical table. All participants provided written informed consent, and the study was approved by the Hospital Ethics Committee (Ethics No. JXEY-2021JX103). The usual care group received a routine education manual at discharge, while the INM group received INM-based health education intervention in addition. Patients were followed up for 6 months for all outcomes, with INR-related outcomes additionally reported at 10 days and 1 month for detailed comparison. Results The INM group showed significantly higher INR compliance rates (98.33% vs. 86.54% at 10 days, χ 2 = 4.021, P = 0.045; 86.67% vs. 57.69% at 1 month, χ 2 = 5.892, P = 0.015), INR monitoring rates (98.33% vs. 84.62% at 10 days, χ 2 = 5.734, P = 0.017; 96.67% vs. 80.77% at 1 month, χ 2 = 4.412, P = 0.036), and medication adherence (88.33% vs. 48.08%, χ 2 = 12.873, P 0.001) than the usual care group. Health knowledge scores were higher in the INM group (29.1 ± 2.1 vs. 22.8 ± 3.0, t = 12.69, P 0.001), as was patient satisfaction (98.33% vs. 90.38%, χ 2 = 5.387, P = 0.020). No significant differences were found in complication or readmission rates (96.67% vs. 94.23%, χ 2 = 2.112, P 0.05). Conclusion The INM significantly enhances patients' understanding of warfarin anticoagulation therapy, improves medication adherence, and boosts self-management skills over a 6-month follow-up, particularly through innovative use of WeChat and cloud-based platforms for real-time education and monitoring.
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