Currently submitted to: Journal of Medical Internet Research
Date Submitted: Mar 23, 2026
Open Peer Review Period: Mar 24, 2026 - May 19, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Co-designing a digital platform for management of modifiable risk factors and comorbidities in atrial fibrillation: a mixed-methods study
ABSTRACT
Background:
Clinical guidelines recommend an integrated, person-centered care model with better control of modifiable risk factors and coexisting conditions in patients with atrial fibrillation (AF), but many persons with AF receive insufficient risk factor management. Digital health technologies may provide valuable support in addressing this gap.
Objective:
Our aim was to evaluate a co-designed digital platform for supporting person-centered management of modifiable risk factors in individuals with AF.
Methods:
This is a mixed-methods study including a standardized quantitative questionnaire used to score the usability of digital tools, the System Usability Scale (SUS), and a qualitative, descriptive, manifest content analysis of individual interviews.
Results:
Twenty-two patients hospitalized for AF were included (age 68 (48-79) years; 32% female; BMI 27.7 (20.8-35.0) kg/m2; paroxysmal/persistent AF (36%/64%); AF duration 4 (0.5-18 years). Relevant comorbidities were hypertension (77%), heart failure (36%), diabetes mellitus type 2 (14%), and ischemic heart disease (18%). Usability was rated high, with a mean SUS score of 75 (±18.2), indicating above-average user acceptance. Participants’ requirements were summarized into four main categories and ten subcategories. First, they value a clear layout with simple design and easy navigation. Second, they appreciate positive content, which is informative, inclusive and motivating. Third, they request personalized information on different aspects and provided on different levels. Fourth, they desire individualized medical recommendations that are personalized and flexible but open to individual choice.
Conclusions:
To improve digital management of lifestyle-related risk factors and comorbidities, individuals with AF seek a solution with a clear layout, positive content, personalized information, and individualized medical recommendations.
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