Usage and the effect on knowledge about atrial fibrillation of an educational application, AF-EduApp

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): The AF-EduApp study is supported by an BMS/Pfizer European Thrombosis Investigator Initiated Research Program (ERISTA) grant. Introduction As the management of atrial fibrillation patients (AF) is complex, an integrated care approach is suggested, including tackling modifying risk factors together with rate and rhythm control and anticoagulation therapy. Patients often underestimate the effect of these pillars on their health and often have poor knowledge about these aspects. As smart devices have become more important in the past decades, they create opportunities to educate patients and improve the follow-up of these patients. Purpose We aimed to evaluate the usage of an in-house developed application, AF-EduApp, and its effect on patients’ AF knowledge levels. Methods A total of 152 patients with AF were included in this multicenter study with a follow-up of 12 to 15 months. One of the modules of the AF-EduApp contains information on AF, its treatment and related self-care. Knowledge about AF and its treatment was assessed through the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) with direct feedback on incorrectly answered questions. The JAKQ (and immediate feedback) were given to the patients via the application at baseline and after 1, 3, 6 and 12 months. Patients are free to decide how frequently they want to use the app (except when questionnaires are available). Results The 152 patients had a total follow-up of 386.8±108.1 days and used the application on 130.1±144.7 days (33.6%). The education module was visited by 135 patients with a median time of 3.1 (IQR: 1.3-21.8) min (mean: 18.6±32.9 min) spent on education. The most visited education chapters were AF treatment (3.1 (0.4-9.5) min) and selfcare (3.1 (0.9-7.1) min)(Fig1). A significant increase in the knowledge level was seen in the 130 patients who completed all 5 moments (p<0.001, Fig 2A). This increase was driven by a significant increase during the first month of follow-up (baseline: 70.4±14.4 vs FU1: 82.4±14.4; p<0.001). The number that one of the 8 questions on AF in general was correctly answered at these 5 time points ranged from 2.7±1.6 to 4.8±0.7 (p<0.001, Fig 2B). The questions ‘Why are most patients with AF prescribed with oral anticoagulation?’ and ‘What is AF?’ were answered best, whereas the questions ‘Is AF always accompanied by symptoms?’ and ‘Can medication prevent AF?’ were most difficult to get right. Conclusion The AF application was reasonably used, about 1 out of every 3 days. Targeted education focused on JAKQ answers that were answered incorrectly significantly improved knowledge level over time. Stronger incentives need to be developed to have patients effectively look at the educational sections that pertain to incomplete knowledge.