Understanding the Attitudes of Clinicians and Patients Toward a Self-Management eHealth Tool for Atrial Fibrillation: Qualitative Study

Research article published on Pubmed. September 17, 2020

AUTHORS: Boon Piang Cher, Gayatri Kembhavi, Kai Yee Toh, Jananie Audimulam, Wei-Yan Aloysius Chia, Hubertus Jm Vrijhoef, Yee Wei Lim, Toon Wei Lim.


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.

Keywords: atrial fibrillation; chronic disease; mHealth; mobile phone; qualitative research; self-management.

©Boon Piang Cher, Gayatri Kembhavi, Kai Yee Toh, Jananie Audimulam, Wei-Yan Aloysius Chia, Hubertus JM Vrijhoef, Yee Wei Lim, Toon Wei Lim. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 17.09.2020.

Keywords: Attitudes, Clinicians, Patients, Self-Management, eHealth Tool, Atrial Fibrillation, Qualitative Study, vrijhoef