OBJECTIVE To evaluate the efficacy of the “Human-GenAI Coexistence” management model among patients with atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants(NOAC), with a particular focus on its impact on the quality of patient management.

METHODS This study enrolled 220 patients with atrial fibrillation who were undergoing NOAC therapy at Renji Hospital, Shanghai Jiao Tong University School of Medicine from May 2024 to May 2025. The patients were randomly assigned to control group and observation group. The control group received management according to the standard outpatient care model, whereas the observation group, in addition to standard care, received decision support and comprehensive management from a collaborative physician-pharmacist clinic, following the innovative “Human-GenAI Coexistence” management model. The patient’s knowledge, adherence, and satisfaction with anticoagulation therapy, adverse clinical event incidence, and prescription qualification rate were all compared between the two groups.

RESULTS The 6-month follow-up data revealed that, compared to the control group, the observation group demonstrated significantly greater improvements in adherence scores(7.90±0.40 vs 7.73±0.60, P=0.014), anticoagulation burden scores(51.72±2.99 vs 50.67±3.62, P=0.021), and anticoagulation benefit scores(12.46±2.35 vs 10.85±1.76, P<0.001). Both groups experienced significant increases in anticoagulation therapy knowledge scores, with the observation group achieving significantly higher scores than the control group(18.26±4.49 vs 15.74±3.77, P<0.001). In assessing the rationality of NOAC prescriptions, the observation group had a significantly higher prescription qualification rate(96.36% vs 88.18%, P=0.023). Additionally, although the incidence of adverse events in the observation group was slightly lower, no statistically significant difference was observed between the two groups.

CONCLUSION Utilizing a tripartite collaborative innovative mechanism that integrates the “medical team-GenAI-patients”, the “Human-GenAI Coexistence” anticoagulation management model significantly improves adherence to anticoagulant therapy, acquisition of relevant knowledge, treatment satisfaction and the prescription rationality in atrial fibrillation patients receiving NOAC. This model also effectively fosters the standardized use of NOAC and offers a crucial reference for enhancing the effectiveness of atrial fibrillation anticoagulation management.