105343Medication Optimisation using mHealth engagementClosedCollaborative R&DInnovate UKThe purpose of this project is to assess the utility of Atom 5, a direct patient-facing technology provided by Aparito, to improve adherence and persistence with oral anticoagulation through increased engagement with a cohort of elderly patients with atrial fibrillation (AF), the commonest form of heart rhythm disturbance that is responsible for over 20% of all strokes. Oral anticoagulants (OACs) are highly effective in stroke prevention in AF and their increased use is an NHS priority. Increased uptake of OACs, particularly of the newer non-vitamin K-antagonist OACs (NOACs), has recently been shown to significantly reduce the annual number of AF-related strokes in England. However, concerns remain about poor adherence and persistence with OACs resulting in suboptimal stroke prevention. We found that 15% of patients do not continue their NOAC in the community after their initial 2-month supply from Barts Health NHS Trust runs out. Other UK studies have reported a similar rate of early non-persistence, increasing to 25% by 12 months. Data are as yet limited on the ability of technologies such as Atom 5 to improve healthcare, in this case through improved medication adherence and persistence, in an elderly population who may be less tech-savvy, yet it is precisely this population that potentially has most to gain from innovative approaches.This project will involve patient engagement to understand their needs and acceptability of such a solution, a clinical trial design developed in partnership with key opinion leaders and a NICE Scientific advice procedure to ensure a data generation strategy that is patient centric, feasible and able to demonstrate clinical and economical value