JMIR Publications

ABSTRACT

Background:

The Center for Disease Control and Prevention has estimated that atrial fibrillation (AF) affects between 2.7-6.1 million people in the United States. Those who have AF tend to have a much higher stroke risk than others. Although most individuals with AF benefit from anticoagulation (AC), a significant majority are hesitant to start it. To add, providers often struggle in helping patients negotiate the decision to start AC. To assist in the communication between patient and provider preferences and knowledge regarding AC, different strategies are being used to try and solve this gap. In this research study, we will have patients and providers utilize the AFib 2getherTM app with hopes that it will create a platform for shared decision-making regarding the prevention of stroke in patients with AF using AC.

Objective:

The aims of our study are to measure several outcomes related to encounters between patients and their cardiology providers where AFib 2getherTM was used. These include usability and perceived usefulness to patients and providers. In addition, we assessed the extent and nature of shared decision-making.

Methods:

Eligible patients and providers will evaluate the AFib 2getherTM mobile app for usability and perceived usefulness in facilitating shared decision-making on understanding the patient’s risk of stroke and whether or not to start AC. Both patients and providers will review the app and complete multiple questionnaires about the usability and perceived usefulness of the mobile app in a clinical setting. We will also audio record a subset of encounters to assess for evidence of shared decision-making.

Results:

Analysis of results is still ongoing.

Conclusions:

The AFib 2getherTM app emerged from the desire to increase patient and provider ability for shared decision-making around understanding the risk of stroke and about AC. We anticipate the AFib 2getherTM mobile app will facilitate patient discussion with their cardiologist and other providers. Additionally, we hope the study will help us identify a focus point in barriers that providers face when placing patients on AC. We aim to demonstrate the usability and perceived usefulness of the app with a future goal of testing the value of our approach in a larger sample of patients and providers at multiple medical centers across the country. Clinical Trial: ClinicalTrials.gov NCT04118270.