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

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

doi:10.2196/15492

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

JMIR Hum Factors. 2020 Sep 17;7(3):e15492. doi: 10.2196/15492.

Authors

Boon Piang Cher¹, Gayatri Kembhavi¹, Kai Yee Toh^#¹, Jananie Audimulam^#¹, Wei-Yan Aloysius Chia¹, Hubertus Jm Vrijhoef^#², Yee Wei Lim³, Toon Wei Lim⁴

Affiliations

¹ Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore.
² Department of Family Medicine and Chronic Care, Department of Patient and Care, University Hospital Maastricht, Maastricht, The Netherlands, Panaxea, Amsterdam, Netherlands.
³ Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴ Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Singapore.

^# Contributed equally.

PMID: 32940611
PMCID: PMC7530695
DOI: 10.2196/15492

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.

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.