Conversational HeAlth supporT in Atrial Fibrillation Self-Management (CHAT-AF-S)

INTERVENTION: The “CHAT‐AF‐S” intervention was co‐designed by the investigator team, clinicians, patient engagement academic experts, behavioural scientists, consumers, and leverages results from previous CHAT‐AF pilot (Australian New Zealand Clinical Trials Registry ACTRN12621000174886). The intervention consists of automated voice calls (with conversational artificial intelligence (AI) technology, including voice recognition and natural language understanding to evaluate participants’ verbal responses), accompanied by educational text messages. The goal of the intervention is to support and monitor patients with atrial fibrillation (AF) by encouraging medication adherence, risk factor reduction and disease self‐management by providing educational content related to AF. This program aims to also identify patients that might be at higher risk of having AF complications (e.g., have poor overall health, unsure if on blood thinner medications, are highly symptomatic and unable to manage their symptoms) by alerting the central clinical management team. OUTREACHES The intervention will consist of a total of si Xpatient outreaches, delivered over the course of 3 months. The outreaches will occur at the following timepoints: 24 – 48 hours, 15 days, 30 days, 45 days, 60 days, and 75 days post‐discharge from hospital services. All these outreaches will be automated following an algorithm. The format of each outreach consists of: 1. Automated phone calls (conversational AI): The first point of contact is via an automated call. If participants are not reached in the first call attempt, the technology will call again in the next 24 hours (3 call attempts). During the automated phone call, patients can respond to queries using their voice (e.g. by saying “Yes”, CONDITION: Atrial Fibrillation; ; Atrial Fibrillation Cardiovascular ‐ Other cardiovascular diseases PRIMARY OUTCOME: Mean Atrial Fibrillation‐related quality of life score, assessed via the Atrial Fibrillation Effect on QualiTy‐of‐life (AFEQT) questionnaire, at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] INCLUSION CRITERIA: Patients will be eligible to participate if they (1) are 18 years old or above, (2) have a documented diagnosis of AF, (3) have a mobile phone that is able to receive calls, (4) are able to receive text messages and open weblinks embedded in them, and (5) are competent with English, as ascertained by the study researcher. SECONDARY OUTCOME: Adherence to atrial fibrillation medication (proportion self‐reported adherence nearly all of the time, assessed using study‐specific questionnaire)[Baseline and 3 months post‐randomisation ] Composite outcome of emergency department presentations and unplanned cardiovascular hospitalisations (self‐reported via study‐specific questionnaire in past 3 months at baseline and at 3 months post‐randomisation)[Baseline and 3 months post‐randomisation ] Mean Atrial Fibrillation knowledge score, assessed via the Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ), at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] Mean Atrial Fibrillation treatment burden score, assessed via the Treatment Burden Questionnaire (TBQ), at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] Mean body mass inde X(calculated based on self‐reported weight and height via study‐specific questionnaire)[Baseline and 3 months post‐randomisation ] Mean Confidence in self‐management of Atrial Fibrillation score, assessed via the Confidence in Atrial fibriLlation Management (CALM) Scale, at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] Mean minutes of physical activity in past week (Validated single‐item physical activity question ‐ Bauman AE, Richards JA. Understanding of the Single‐Item Physical Activity Question for Population Surveillance. Journal of Physical Activity and Health. 2022 Sep 19;19(10):681‐6.)[Baseline and 3 months post‐randomisation ] Mean servings of fruit consumed on average each day over the last month (self‐reported using a validated questionnaire) at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] Mean servings of vegetables consumed on average each day over the last month (self‐reported using a validated questionnaire) at 3 months in intervention versus control group.[Baseline and 3 months post‐randomisation ] Proportion of non‐smokers at 3 months (out of those who were identified as current smokers at baseline) using a study specific questionnaire.[Baseline and 3 months post‐randomisation ] Proportion of participants drinking 1 or less alcoholic beverages per week (self‐reported via study‐specific questionnaire)[Baseline and 3 months post‐randomisation ]