Episodic Future Thinking to Improve Anticoagulant Adherence in Atrial Fibrillation

NCT07174778 | Not Yet Recruiting

• 1 other identifier: L2025SYSU-HL-022
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 2

Brief Summary

The purpose of this study is to assess the effectiveness of Episodic Future Thinking (EFT) on improving medication adherence in atrial fibrillation (AF) patients taking oral anticoagulants. A total of 68 participants will be randomly assigned to the intervention group or the control group. Those in the intervention group will receive a 3-week EFT intervention in addition to the usual care, while those in the control group will receive the usual care only. Data on medication adherence, delay discounting (DD), and anticoagulation knowledge will be collected at baseline, end of intervention, and 3-month follow-up.

Conditions

Atrial Fibrillation (AF)

Keywords

Atrial Fibrillation; Stroke; Episodic Future Thinking; Delay Discounting

Outcome Measures

Primary Outcomes (1)

• Medication adherence

  This study assessed oral anticoagulant adherence using the General Medication Adherence Scale (GMAS) . The 11-item scale evaluates three dimensions: (1) patient behavior related non-adherence (five items), (2) additional disease and pill burden (four items) and (3) cost-related non-adherence (two items). Each item is rated on the scale that 0 = always, 1 = mostly, 2 = sometimes, and 3 = never. Higher scores indicate better adherence and it was divided into five levels according to different scores: 30-33 (high adherence), 27-29 (good adherence), 17-26 (moderate adherence), 11-16 (low adherence), and 0-10 (poor adherence).

  Baseline, 3 weeks and 15 weeks

Secondary Outcomes (3)

• Delay discounting for money

  Baseline, 3 weeks, 15 weeks

• Delay discounting for health

  Baseline, 3 weeks and 15 weeks

• Anticoagulation knowledge

  Baseline, 3 weeks, 15 weeks

Study Arms (2)

Episodic future thinking

EXPERIMENTAL

Participants will generate individualized episodic future events and transform them to text-based and picture-based cues which will reminder participants to re-imagine their future events in their daily life.

Behavioral: Episodic future thinking

Attention control

PLACEBO COMPARATOR

Researchers will maintain equal contact frequency with controls, limited to general check-in messages.

Behavioral: attention control

Interventions

Episodic future thinking BEHAVIORAL

Participants will engage in episodic future thinking prompted via text-based cues and picture-based cues to help them adhere to oral anticoagulants. Participants will also receive health education on atrial fibrillation-related stroke prevention.

Episodic future thinking

attention control BEHAVIORAL

The control group will receive standard care, including routine health education from ward nurses and one post-discharge telephone follow-up. In additon, participants will receive a message from the researcher at the same time point each day, but the message will only involve daily greetings.

Attention control

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Meets diagnostic criteria for atrial fibrillation per the Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation, with clinically stable condition
• Current or previous use of oral anticoagulants
• Age ≥18 years
• Capable of using WeChat mobile application
• Willing to provide informed consent

You may not qualify if:

• Comorbid severe impairment of major organ systems or end-stage disease
• Significant visual or auditory impairments
• Documented cognitive dysfunction or psychiatric disorders (e.g., major depressive disorder, schizophrenia, bipolar disorder)

Sponsors & Collaborators

• Jiawen You: lead

Study Sites (2)

Guangdong Provincial People's Hospital

Guangzhou, Gangdong, 510080, China

Location

The First Affiliated Hospital of Sun Yat-sen University

Guangzhou, Gangdong, 510080, China

Location

MeSH Terms

Conditions

Atrial Fibrillation; Stroke

Condition Hierarchy (Ancestors)

Arrhythmias, Cardiac; Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases

Central Study Contacts

Jiawen You

CONTACT

0086-15280095563; youjw@mail2.sysu.edu.cn

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Postgraduate student

Study Record Dates

• First Submitted: September 6, 2025
• First Posted: September 16, 2025
• Study Start: September 15, 2025
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): March 31, 2027
• Last Updated: September 16, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

CN (2)