Effectiveness and usability of an online tailored education platform for atrial fibrillation patients undergoing a direct current cardioversion or pulmonary vein isolation.

BACKGROUND Atrial fibrillation (AF) care should strive for more informed, involved and empowered patients. However, few effective educational programs are available. The aim of this study was to evaluate the effectiveness of an online tailored education platform to inform AF patients undergoing a direct current cardioversion (DCC) or a pulmonary vein isolation (PVI). METHODS 120 AF patients requiring DCC or PVI were allocated to an online education group (n = 35), a standard care group despite having online access (n = 36; randomized with group 1), and a group without a computer/tablet/smartphone receiving standard care (n = 49). The Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ), supplemented with procedure-specific questions, had to be completed 1-3 weeks before hospitalization, at hospitalization, and 6 and/or 12 weeks post-procedurally. RESULTS Major AF-related and procedure-related knowledge gaps were shown. The online tailored education group scored significantly better at hospitalization compared to baseline (P = 0.001). This knowledge increase was retained after 6 (P = 0.010) and 12 (P < 0.001) weeks. In the online standard care group there was no change in knowledge from planning till hospitalization (P = 1.000), although knowledge was improved 6 weeks post-procedurally (P = 0.010). Knowledge did not improve in the group without computer/tablet/smartphone at any time (P = 0.248). Most patients indicated that the platform was easy to use (87.9%), understandable (97.0%), and 72.7% indicated that an online platform was their preferred way to receive future AF-related information. CONCLUSIONS Tailored online education is an effective strategy to improve AF- and procedure-related knowledge with lasting effects up to 12 weeks post-procedurally. The platform was positively evaluated by patients.

[1]  K. Cao,et al.  Knowledge, attitude, and behavior in patients with atrial fibrillation undergoing radiofrequency catheter ablation , 2010, Journal of Interventional Cardiac Electrophysiology.

[2]  Martin Schrepp,et al.  Construction and Evaluation of a User Experience Questionnaire , 2008, USAB.

[3]  Paul Dendale,et al.  P817Effect of individualised education sessions on the knowledge level of patients with atrial fibrillation , 2017 .

[4]  A. Berghold,et al.  Does a complex intervention increase patient knowledge about oral anticoagulation? - a cluster-randomised controlled trial , 2017, BMC Family Practice.

[5]  Yutao Guo,et al.  Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial. , 2017, The American journal of medicine.

[6]  R. Tieleman,et al.  The atrial fibrillation knowledge scale: development, validation and results. , 2013, International journal of cardiology.

[7]  Panos Vardas,et al.  European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers , 2017, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[8]  B. Bajorek,et al.  Assessment of Web‐based education resources informing patients about stroke prevention in atrial fibrillation , 2016, Journal of clinical pharmacy and therapeutics.

[9]  B. Gorenek,et al.  Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisi , 2015, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[10]  G. Lip,et al.  Educational Intervention Improves Anticoagulation Control in Atrial Fibrillation Patients: The TREAT Randomised Trial , 2013, PloS one.

[11]  H. Heidbuchel,et al.  Knowledge gaps in patients with atrial fibrillation revealed by a new validated knowledge questionnaire. , 2016, International journal of cardiology.

[12]  B. Horne,et al.  Warfarin Knowledge in Patients with Atrial Fibrillation: Implications for Safety, Efficacy, and Education Strategies , 2010, Cardiology.

[13]  G. Lip,et al.  Patients' understanding of anticoagulant therapy in a multiethnic population. , 2003, Journal of the Royal Society of Medicine.

[14]  L. Cronbach Coefficient alpha and the internal structure of tests , 1951 .

[15]  T. Grodzicki,et al.  Knowledge of antithrombotic prophylaxis among patients with atrial fibrillation. , 2007, Cardiology journal.

[16]  T. Potpara,et al.  Differences in attitude, education, and knowledge about oral anticoagulation therapy among patients with atrial fibrillation in Europe: result of a self-assessment patient survey conducted by the European Heart Rhythm Association. , 2016, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[17]  Emily C. O'Brien,et al.  Disease understanding in patients newly diagnosed with atrial fibrillation , 2017, Heart.

[18]  P. Kirchhof,et al.  2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. , 2016, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[19]  Pamela J. McCabe,et al.  Knowledge and self-management behaviors of patients with recently detected atrial fibrillation. , 2006, Heart & lung : the journal of critical care.

[20]  H. Heidbuchel,et al.  Differences in knowledge among patients with atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants and vitamin K antagonists. , 2018, Kardiologia polska.

[21]  John Spertus,et al.  Development and Validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in Patients With Atrial Fibrillation , 2011, Circulation. Arrhythmia and electrophysiology.

[22]  T. Potpara,et al.  Patients' attitude and knowledge about oral anticoagulation therapy: results of a self-assessment survey in patients with atrial fibrillation conducted by the European Heart Rhythm Association. , 2016, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[23]  G. Lip,et al.  Best practice for atrial fibrillation patient education. , 2014, Current pharmaceutical design.

[24]  H. Leino‐Kilpi,et al.  Patient knowledge of atrial fibrillation: 3-month follow-up after an emergency room visit. , 2008, Journal of advanced nursing.

[25]  H. Crijns,et al.  The effect of a nurse-led integrated chronic care approach on quality of life in patients with atrial fibrillation. , 2014, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[26]  G. Breithardt,et al.  An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality , 2010, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[27]  G. Lip,et al.  Patient knowledge and perceptions of atrial fibrillation and anticoagulant therapy: effects of an educational intervention programme. The West Birmingham Atrial Fibrillation Project. , 2006, International journal of cardiology.

[28]  T. Potpara,et al.  How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey. , 2015, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.