Understanding the attitudes of clinicians and patients toward a self-management eHealth tool for atrial fibrillation: Qualitative study

Abstract

Background: Atrial fibrillation (AF) is the most common heart rhythm disorder and poses a growing disease burden worldwide because of an aging population. A multidisciplinary approach with an emphasis on patient education and self-management has been demonstrated to improve outcomes for AF through the engagement of patients in their own care. Although electronic tools (e-tools) such as apps have been proposed to provide patient education and facilitate self-management, there have been few studies to guide the development of these tools for patients with AF. Objective: This study aims to explore the perceptions of patients and health care providers (HCPs) and their attitudes toward the use of e-tools for the self-management of AF. It also seeks to elicit the factors that contribute to these attitudes. Methods: Semistructured qualitative interviews with HCPs and patients were conducted to understand the interpretations and expectations of an e-tool that would be used for the self-management of AF. Interview data were analyzed using an exploratory thematic analysis approach to uncover emergent themes and infer ideas of preferred features in a device. A modified technology acceptance model was developed as a framework to help interpret these findings. Data from the HCPs and patients were compared and contrasted. Results: Both patients and HCPs thought that an e-tool would be useful in the self-management of AF. Although both groups favored educational content and monitoring of blood pressure, patients expressed more passivity toward self-care and an ambivalence toward the use of technology to monitor their medical condition. This appears to be related to factors such as a patient's age, social support, and their attitudes toward technology. Instead, they favored using the app to contact their HCPs. Conclusions: This study provides insights into significant differences in the attitudes of patients and HCPs toward the use of e-tools for self-care against their priorities. Understanding patients' motivations and their needs are key to ensuring higher acceptance of such tools. © 2020 Boon Piang Cher, Gayatri Kembhavi, Kai Yee Toh, Jananie Audimulam, Wei-Yan Aloysius Chia, Hubertus JM Vrijhoef, Yee Wei Lim, Toon Wei Lim.