A pilot study to validate the AF-EduApp, a new mobile application for targeted education and management of atrial fibrillation patients.

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia and associated with an increased risk for stroke. Previously performed research demonstrated important knowledge gaps of patients about AF and its treatment. This lack of knowledge can contribute to reduced therapy adherence. Further, increasing smartphone ownership in patients with an age of 65 years or older, (i.e. the typical AF population) is seen. In Belgium, this number increased from 35% in 2017 to 52% in 2018. This digital growth creates an opportunity to support patients in their care via mobile applications. Purpose: The aim of this pilot study was to evaluate a newly developed application for AF patients, AF-EduApp (iOS and Android). We assessed its daily use and impact on patient knowledge. Methods: The AF-EduApp consists of six different modules: medication overview with reminders, education, questionnaires for patient feedback, measurements (e.g. blood pressure, heart rate), appointments, and the possibility to ask questions to the caregivers. A prototype of the application was validated and optimized for its usability and functionality in two phases. After a content and face validation via short interviews of both experts and patients, a pilot study of one month was performed. Twenty patients evaluated the app in which user data, patients' knowledge and satisfaction were assessed. Results: After the pilot study, 17 of the 20 patients found the application easy in use and attractive. In addition, 80% indicated that the app was useful in their AF care and follow-up and they wanted to use the app for a longer period. Patients used the app approximately 43% of the days. The top three used modules were the measurement module (55%), education module (21%) and medication module (13%). When patients opened the education module, they spent an average of 11 minutes in this module. A significant improvement of knowledge was already seen after one month usage of the app (baseline score of 73.4% and 85% after one month; p=0.013). Conclusion: First results show that the AF-EduApp can be used in daily practice. The app received a positive evaluation from both experts and patients and could further be improved through validation by patients. The app is now being used in an RCT to evaluate its effect on therapy adherence.