The Danish Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: Design and Pilot Study in Collaboration with Patients and Their Spouses
ABSTRACT
Background:
Atrial fibrillation is the most common cardiac arrhythmia and is predicted to more than double in prevalence over the next 20 years. Tailored patient education is recommended as an important aspect of atrial fibrillation care. Current guidelines emphasize measures enabling patients to become more active participants in the management of their own disease, yet there are no rehabilitation programs for AF patients in the Danish healthcare system.
Objective:
The aims of this pilot study were to identify the challenges facing patients with atrial fibrillation and their relatives and based upon this, to design and pilot test a telerehabilitation program.
Methods:
A participatory design process was divided into a phase 0 and a phase 1, and took place from December 2018 to March 2020. Phase 0 consisted of interviews, cultural probes, and workshops with the aim of identifying and prioritizing challenges of living with atrial fibrillation in everyday life as they affect atrial fibrillation patients and their relatives, as well as to design scenarios for telerehabilitation programs for patients with atrial fibrillation. Phase 1 was conducted as a pilot study with the aim to evaluate and compare the feasibility of two scenarios of telerehabilitation programs for atrial fibrillation patients.
Results:
The main results of iterations 1 and 2 were the following challenges listed in a prioritized order: Lack of knowledge of everyday stresses, psychological influence, physical limitations, insecurity about being diagnosed and living with atrial fibrillation, and uncertainty about the role of the relative. In iteration 3, two scenarios of telerehabilitation programs, A and B, were designed, and a web-based interactive HeartPortal for patients with atrial fibrillation was created. In iteration 4, a pilot study of the two telerehabilitation programs was tested and evaluated.
Conclusions:
Patients with atrial fibrillation and their relatives were positive about a telerehabilitation program. Patients with atrial fibrillation and their relatives found the telerehabilitation program useful, especially because it created an increased sense of security, knowledge about mastering their symptoms and a community of practice linking patients with atrial fibrillation and their relatives and healthcare personnel. Clinical Trial: ClinicalTrials.gov NCT04493437; https://clinicaltrials.gov/ct2/show/NCT04493437
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