Mobile health applications for atrial fibrillation: A readability and quality assessment

Ayyaswami, Varun; Padmanabhan, Divya; Crihalmeanu, Tudor; Thelmo, Franklin; Prabhu, Arpan V.; Magnani, Jared W.

doi:10.1016/j.ijcard.2019.07.026

Cited by 31 publications

(35 citation statements)

References 23 publications

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“…Although numerous apps related to the detection or management of AF exist, recent reviews have found that these apps vary in quality [40] and accuracy [21]. A recent review of 102 apps for patients with AF available on from Apple or Google Play found that the majority of the apps included information about AF and AF detection, and a quarter to a third of apps included symptom journals or medication reminders, and 1 app included a patient support community [40]. A quarter depended on an additional device [40].…”

Section: Discussionmentioning

confidence: 99%

“…A recent review of 102 apps for patients with AF available on from Apple or Google Play found that the majority of the apps included information about AF and AF detection, and a quarter to a third of apps included symptom journals or medication reminders, and 1 app included a patient support community [40]. A quarter depended on an additional device [40]. The review did not report which apps included functionality allowing patients to communicate directly with their health care teams.…”

Section: Discussionmentioning

confidence: 99%

“…The review did not report which apps included functionality allowing patients to communicate directly with their health care teams. Unfortunately, the review found that less than a fifth of apps (16% of apps from Apple and 13% from Google Play) included scientifically validated content [40]. Results of pilot studies of apps to help patients manage their AF appear promising [10].…”

Section: Discussionmentioning

confidence: 99%

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Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

Waring¹,

Hills²,

Lessard³

et al. 2019

JMIR Cardio

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BackgroundOnline support groups for atrial fibrillation (AF) and apps to detect and manage AF exist, but the scientific literature does not describe which patients are interested in digital disease support.ObjectiveThe objective of this study was to describe characteristics associated with Facebook use and interest in digital disease support among older patients with AF who used the internet.MethodsWe used baseline data from the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF), a prospective cohort of older adults (≥65 years) with AF at high stroke risk. Participants self-reported demographics, clinical characteristics, and Facebook and technology use. Online patients (internet use in the past 4 weeks) were asked whether they would be interested in participating in an online support AF community. Mobile users (owns smartphone and/or tablet) were asked about interest in communicating with their health care team about their AF-related health using a secure app. Logistic regression models identified crude and multivariable predictors of Facebook use and interest in digital disease support.ResultsOnline patients (N=816) were aged 74.2 (SD 6.6) years, 47.8% (390/816) were female, and 91.1% (743/816) were non-Hispanic white. Roughly half (52.5%; 428/816) used Facebook. Facebook use was more common among women (adjusted odds ratio [aOR] 2.21, 95% CI 1.66-2.95) and patients with mild to severe depressive symptoms (aOR 1.50, 95% CI 1.08-2.10) and less common among patients aged ≥85 years (aOR 0.27, 95% CI 0.15-0.48). Forty percent (40.4%; 330/816) reported interest in an online AF patient community. Interest in an online AF patient community was more common among online patients with some college/trade school or Bachelors/graduate school (aOR 1.70, 95% CI 1.10-2.61 and aOR 1.82, 95% CI 1.13-2.92, respectively), obesity (aOR 1.65, 95% CI 1.08-2.52), online health information seeking at most weekly or multiple times per week (aOR 1.84, 95% CI 1.32-2.56 and aOR 2.78, 95% CI 1.86-4.16, respectively), and daily Facebook use (aOR 1.76, 95% CI 1.26-2.46). Among mobile users, 51.8% (324/626) reported interest in communicating with their health care team via a mobile app. Interest in app-mediated communication was less likely among women (aOR 0.48, 95% CI 0.34-0.68) and more common among online patients who had completed trade school/some college versus high school/General Educational Development (aOR 1.95, 95% CI 1.17-3.22), sought online health information at most weekly or multiple times per week (aOR 1.86, 95% CI 1.27-2.74 and aOR 2.24, 95% CI 1.39-3.62, respectively), and had health-related apps (aOR 3.92, 95% CI 2.62-5.86).ConclusionsAmong older adults with AF who use the internet, technology use and demographics are associated with interest in digital disease support. Clinics and health care providers may wish to encourage patients to join an existing online support community for AF and explore opportunities for app-mediated patient-provider communication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

Waring¹,

Hills²,

Lessard³

et al. 2019

JMIR Cardio

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“…Finally, a multidisciplinary effort by regulatory agencies, healthcare organizations, and app stores is required to improve relevance, scientific validity, and readability of AF apps for AF patients. [44] Additionally, discussions with insurance companies about reimbursement of mHealth infrastructures and with different stakeholders to agree on security and privacy regulations are initiated in different countries. [31,45] 7 | CONCLUSION Health tools in the management of AF are becoming indispensable in current healthcare.…”

Section: Further Challenges For Implementation Of Mhealth In Clinicmentioning

confidence: 99%

On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

Hermans¹,

Velden²,

Gawałko

et al. 2020

Clinical Cardiology

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Background: Although novel teleconsultation solutions can deliver remote situations that are relatively similar to face-to-face interaction, remote assessment of heart rate and rhythm as well as risk factors remains challenging in patients with atrial fibrillation (AF). Hypothesis. Mobile health (mHealth) solutions can support remote AF management. Methods: Herein, we discuss available mHealth tools and strategies on how to incorporate the remote assessment of heart rate, rhythm and risk factors to allow comprehensive AF management through teleconsultation. Results: Particularly, in the light of the coronavirus disease 2019 (COVID-19) pandemic, there is decreased capacity to see patients in the outpatient clinic and mHealth has become an important component of many AF outpatient clinics. Several validated mHealth solutions are available for remote heart rate and rhythm monitoring as well as for risk factor assessment. mHealth technologies can be used for (semi-)continuous longitudinal monitoring or for short-term on-demand monitoring, dependent on the respective requirements and clinical scenarios. As a possible solution to improve remote AF care through teleconsultation, we introduce the on-demand TeleCheck-AF mHealth approach that allows remote app-based assessment of heart rate and rhythm around teleconsultations, which has been developed and implemented during the COVID-19 pandemic in Europe. Conclusion: Large scale international mHealth projects, such as TeleCheck-AF, will provide insight into the additional value and potential limitations of mHealth strategies to remotely manage AF patients. Such mHealth infrastructures may be well suited within an integrated AF-clinic, which may require redesign of practice and reform of health care systems. How to cite this article: Hermans ANL, van der Velden RMJ, Gawalko M, et al. On-demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation.

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“…One large area of innovation is in engaging patients in mobile health. Although currently there are over 100,000 apps to download from the Google Play and Apple App stores, very few have been studied in randomized controlled trials [ 17 ], and the apps are written at a grade level higher than the reading level of the patients [ 18 ]. The strength of using mobile health technology lies in its ability to engage the patient via customized interventions [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Elderly Medication Adherence Intervention Using the My Interventional Drug-Eluting Stent Educational App: Multisite Randomized Feasibility Trial

Boyd

Ndukwe

Dileep

et al. 2020

JMIR Mhealth Uhealth

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Background A lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin. Objective This study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. Methods Potential participants who received a post percutaneous coronary intervention (PCI) procedure with a drug-eluting stent were approached. All patients older than 50 years and who spoke English were recruited. Participants were recruited, baseline demographics were collected, and the Hospital Anxiety and Depression Scale (HADS), Rapid Estimate of Adult Literacy in Medicine-Short Form, Burden-Benefit questionnaire, 36-Item Short Form Health Survey, and PCI knowledge questionnaire were administered. Block randomization was used to randomize participants to either usual care or MyIDEA supplementation. MyIDEA is a personalized educational intervention based on the Kolb experiential learning theory using patient narratives for education. During the visits, participants’ blood was collected to measure platelet suppression from medication. During the second and third encounters, the Morisky medication adherence score and cardiology outcomes were measured. The study was conducted at the University of Illinois Hospital and John H Stroger Jr Cook County Hospital with appropriate ethical approvals. Platelet suppression was measured through aspirin reactive units and P2Y12 reactive units. Medication adherence was measured using the PDC. The analysis team was blinded to the participants’ group membership. The primary outcome was a feasibility analysis of recruitment and retention. Results The mean age of participants was 60.4 years (SD 7.1); the majority of patients were black and non-Hispanic. The majority of patients’ reading levels were seventh grade or above, and they were not very familiar with other electronic devices for information and communication. The number of control subjects was 21, and the number of participants in the interventional arm was 24. The interventional group was able to use MyIDEA in both the hospital and outpatient setting. However, there was no significant difference in platelet suppression or medication adherence between groups. There were also differences between the groups in terms of depression and anxiety, initially, as measured by HADS. No documented adverse event associated with the intervention was found. Conclusions Elderly patients are willing to use tablet devices to be educated about health conditions. Additional studies are required to measure the effectiveness and determine the most suitable timing and location for patient education. Trial Registration ClinicalTrials.gov NCT04439864; https://clinicaltrials.gov/ct2/show/NCT04439864

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Mobile health applications for atrial fibrillation: A readability and quality assessment

Cited by 31 publications

References 23 publications

Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

Characteristics Associated With Facebook Use and Interest in Digital Disease Support Among Older Adults With Atrial Fibrillation: Cross-Sectional Analysis of Baseline Data From the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) Cohort

On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

Elderly Medication Adherence Intervention Using the My Interventional Drug-Eluting Stent Educational App: Multisite Randomized Feasibility Trial

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