Patient motivation and adherence to an on-demand app-based heart rate and rhythm monitoring for atrial fibrillation management: data from the TeleCheck-AF project

Abstract

Aims The aim of this TeleCheck-AF sub-analysis was to evaluate motivation and adherence to on-demand heart rate/rhythm monitoring app in patients with atrial fibrillation (AF). Methods and results Patients were instructed to perform 60 s app-based heart rate/rhythm recordings 3 times daily and in case of symptoms for 7 consecutive days prior to teleconsultation. Motivation was defined as number of days in which the expected number of measurements (≥3/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period. Data from 990 consecutive patients with diagnosed AF [median age 64 (57–71) years, 39% female] from 10 centres were analyzed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 28% of the study population and had a lower percentage of recordings in sinus rhythm [90 (53–100%) vs. 100 (64–100%), P < 0.001] compared with others. Older age and absence of diabetes were predictors of both optimal motivation and adherence [odds ratio (OR) 1.02, 95% coincidence interval (95% CI): 1.01–1.04, P < 0.001 and OR: 0.49, 95% CI: 0.28–0.86, P = 0.013, respectively]. Patients with 100% motivation also had ≥100% adherence. Independent predictors for optimal adherence alone were older age (OR: 1.02, 95% CI: 1.00–1.04, P = 0.014), female sex (OR: 1.70, 95% CI: 1.29–2.23, P < 0.001), previous AF ablation (OR: 1.35, 95% CI: 1.03–1.07, P = 0.028). Conclusion In the TeleCheck-AF project, more than one-fourth of patients had optimal motivation and adherence to app-based heart rate/rhythm monitoring. Older age and absence of diabetes were predictors of optimal motivation/adherence.

Photoplethysmography-documented atrial fibrillation in the first week after catheter ablation is associated with lower success rates

“…Of note, the total inclusion rate of 31% in this single centre study was relatively low in our series of consecutive patients and younger patients were more willing to participate in the study. These two observations differ from the overall results of the complete TeleCheck-AF analysis ( 23 ). This may be attributed to the pragmatic onboarding approach or clinical scenario specific factors including general scepticism towards the technology, the timepoint of inclusion during the long preparatory outpatient visit prior to ablation, or limited digital literacy.…”

“…This may be attributed to the pragmatic onboarding approach or clinical scenario specific factors including general scepticism towards the technology, the timepoint of inclusion during the long preparatory outpatient visit prior to ablation, or limited digital literacy. Additionally, motivation and adherence to perform the recommended number of measurements was lower than in the total TeleCheck-AF cohort ( 23 ). However, the higher motivation and adherence in those patients who recorded arrhythmias might reflect the importance of the symptom-driven recordings in this specific clinical scenario post PVI.…”

Compliance Challenges in a Longitudinal COVID-19 Cohort Using Wearables for Continuous Monitoring: Observational Study

“…Our population’s mean age was younger; therefore, the trend of compliance increasing with age is in agreement with previous studies. A subanalysis of the TeleCheck-AF study showed that compliance increased with age [ 27 ]. In general, this tendency can be explained by several factors.…”

Atrial fibrillation: epidemiology, screening and digital health

“…Data indicate a positive center and patient experience. 50 The effect of this intervention on clinical outcomes will be investigated in a RCT. A structured follow-up packages guiding the rehabilitation at home have been updated for mAFA (mAFA III) and are suitable for patients receiving drug treatment only or left atrial appendage occluder.…”