Intelligent mobile health management for the risk of gastrointestinal bleeding in anticoagulated patients with cardiovascular disease

Li, Ting; Zhang, Jingtao; Li, Hua; Zhang, Qinhu; Jiang, Xiaoman; Ma, Jingjing; Feng, Yan

doi:10.1590/1980-220X-REEUSP-2025-0311en

Sumário Anterior Atual Seguinte

Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 60 • 2026 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0311en linkcopy

Intelligent mobile health management for the risk of gastrointestinal bleeding in anticoagulated patients with cardiovascular disease

Gestão inteligente móvel de saúde para o risco de hemorragia gastrointestinal em pacientes anticoagulados com doença cardiovascular

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To evaluate the effectiveness of a mobile health (mHealth)-based smart management strategy for reducing the risk of gastrointestinal bleeding in patients with cardiovascular disease undergoing anticoagulant therapy.

Method: A retrospective observational study was conducted in a tertiary hospital, with patients undergoing anticoagulant therapy being allocated to conventional and smart groups. mHealth technology-based monitoring tools, standardized questionnaires for disease knowledge and self-assessment scales for anxiety and depression were used.

Results: Related to hemostasis and satisfaction with the nursing staff were evaluated using t-tests and chi-square tests; p-values <0.05 were considered significant.

Results: The mHealth-based smart management strategy showed a positive association with disease knowledge, a better psychological state, a shorter hemostasis time, and greater satisfaction with nursing care (P < 0.05).

Conclusion: A smart management strategy based on mHealth was associated with better clinical and psychological outcomes than the conventional guidance group.

DESCRIPTORS
Blood Coagulation; Cardiovascular Disease; Gastrointestinal Hemorrhage; Intelligence; Risk.

Variable	Conventional group (n = 52)	Intelligent group (n = 60)	P value
Age (years)	46.36 ± 4.26	45.94 ± 5.31	0.464
Sex (male/female)	29/23	35/25	0.934
Atrial fibrillation, n (%)	18 (34.6)	21 (35.0)	0.875
Angina, n (%)	9 (17.3)	10 (16.7)	0.871
Myocardial infarction, n (%)	12 (23.1)	15 (25.0)	0.987
Pulmonary embolism, n (%)	5 (9.6)	8 (13.3)	0.751

Group	n	Ineffective	Effective	Markedly effective	Response rate
Conventional	52	7 (13.46)	24 (46.15)	21 (40.38)	45 (86.54)
Intelligent	60	1 (1.67)	23 (38.33)	36 (60.00)	59 (98.33)
χ²					5.843
P					0.016

Group	n	Time to hemostasis (h)	GBS (point)
Group	n	Time to hemostasis (h)	Before implementation	After implementation
Conventional	52	32.15 ± 4.89	10.58 ± 2.10	7.97 ± 1.33*
Intelligent	60	23.59 ± 2.36	11.25 ± 2.49	6.11 ± 1.51*
t		12.043	1.526	6.868
P		<0.001	0.130	<0.001

Group	n	Disease knowledge		Early bleeding identification		Self-care during bleeding		First aid measures
Group	n	Before implementation	After implementation	Before implementation	After implementation	Before implementation	After implementation	Before implementation	After implementation
Conventional	52	72.65 ± 7.83	88.63 ± 5.68*	74.22 ± 9.12	89.72 ± 5.49*	70.02 ± 8.70	89.71 ± 4.85*	71.62 ± 8.16	90.35 ± 4.82*
Intelligent	60	73.15 ± 7.73	94.06 ± 4.02*	72.38 ± 9.60	92.15 ± 4.85*	72.16 ± 7.72	93.50 ± 4.29*	71.16 ± 8.26	94.23 ± 3.68*
t		0.339	5.896	1.035	2.487	1.379	4.389	0.296	4.822
P		0.735	<0.001	0.303	0.014	0.171	<0.001	0.768	<0.001
Group	n	Dietary guidelines			Medication guidelines			Relapse prevention
Group	n	Before implementation	After implementation		Before implementation	After implementation		Before implementation	After implementation
Conventional	52	77.61 ± 8.82	92.66 ± 3.63*		75.17 ± 6.40	91.21 ± 4.42*		73.22 ± 8.60	90.89 ± 4.00*
Intelligent	60	76.85 ± 7.54	95.50 ± 2.71*		76.07 ± 7.65	93.36 ± 3.81*		73.82 ± 8.02	93.83 ± 3.54*
t		0.492	4.729		0.669	2.765		0.382	4.127
P		0.624	<0.001		0.505	0.007		0.703	<0.001

Group	n	SDS score (point)		SAS score (point)
Group	n	Before implementation	After implementation	Before implementation	After implementation
Conventional	52	61.35 ± 3.95	46.41 ± 2.44*	62.80 ± 5.74	46.30 ± 4.22*
Intelligent	60	62.23 ± 4.82	43.31 ± 2.25*	63.85 ± 5.61	41.45 ± 3.58*
t		1.047	6.992	0.977	6.581
P		0.298	<0.001	0.331	<0.001

Group	n	Dissatisfied	Generally satisfied	Largely satisfied	Highly satisfied	Satisfaction
Conventional	52	12 (23.08)	18 (34.62)	12 (23.08)	10 (19.23)	40 (76.92)
Intelligent	60	3 (5.00)	15 (25.00)	20 (33.33)	22 (36.67)	57 (95.00)
χ²						7.848
P						0.005

location_on

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[T3FN1] P < 0.05 vs. this group before implementation.