Effect of internet plus nursing mode telehealth intervention on warfarin management in atrial fibrillation patients

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.