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. 2023 May 25;22(4):412-424.
doi: 10.1093/eurjcn/zvac061.

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

Monika Gawałko  1   2   3 , Astrid N L Hermans  1 , Rachel M J van der Velden  1 , Konstanze Betz  1 , Dominique Vm Verhaert  1   4 , Henrike A K Hillmann  5 , Daniel Scherr  6 , Julia Meier  6 , Arian Sultan  7 , Daniel Steven  7 , Elena Terentieva  7 , Ron Pisters  8 , Martin Hemels  8 , Leonard Voorhout  8 , Piotr Lodziński  3 , Bartosz Krzowski  3 , Dhiraj Gupta  9 , Nikola Kozhuharov  9   10 , Laurent Pison  11 , Henri Gruwez  11   12 , Lien Desteghe  13   14 , Hein Heidbuchel  13 , Stijn Evens  15 , Emma Svennberg  16 , Tom de Potter  17 , Kevin Vernooy  1 , Nikki A Ha Pluymaekers  1 , Martin Manninger  6 , David Duncker  5 , Afzal Sohaib  18   19 , Dominik Linz  1   4   20   21 , Jeroen M Hendriks  20   22
Affiliations

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

Monika Gawałko et al. Eur J Cardiovasc Nurs. .

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.

Keywords: Atrial fibrillation; Mobile health; Photoplethysmography; Risk factors; Thromboembolic risk.

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Conflict of interest statement

Conflict of interests: M.G., A.N.L.H., R.M.J.v.d.V., K.B., D.V.M.V., H.A.K.Hi., D.Sc., J.M., A.Su., D.St., E.T., R.P., M.H., L.V., P.L., B.K., L.P., H.G., L.D., H.He., T.d.P., N.A.H.A.P., A.So., D.L., J.M.H. declared no conflicts of interest. D.G. received PI for institutional research grants from Biosense Webster, Boston Scientific, and Medtronic. N.K. has received research grants from the Swiss National Science Foundation (P400PM-194477), Gottfried und Julia Bangerter-Rhyner-Stiftung, and the European Society of Cardiology. S.E. was employed by Qompium NV. K.V. is a consultant for Medronic, Abbott, Biosense Webster, Philips. M.M. has received speaker honoraria and/or travel grants from Biosense Webster, Abbott, Biotronik, Zoll, Boston Scientific, Daiichi Sankyo, Bayer, Pfizer, Amomed, as well as research grants from Biosense Webster. D.D. received lecture honorary, travel grants and/or a fellowship grant from Abbott, Astra Zeneca, Bayer, Biotronik, Bristol-Myers Squibb, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Medtronic, Microport, Pfizer, Zoll. E.S. has received institutional lecture/consulting fees from lecture fees from Bayer, Bristol-Myers Squibb-Pfizer, Boehringer- Ingelheim, Johnson & Johnson, Merck Sharp & Dohme, and Sanofi.