SPC365

Digital follow-up program for patients undergoing atrial fibrillation ablation: the experience of a Portuguese center

Session: Comunicações Orais - Sessão 19 - Saúde Digital e Economia da Saúde
Speaker: Mariana Silva Brandão

Congress: CPC 2023
Topic: N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme: 33. e-Cardiology / Digital Health
Subtheme: 33.4 Digital Health
Session Type: Comunicações Orais
FP Number: ---
Authors: Mariana S. Brandão; Rafael Silva-Teixeira; João Gonçalves Almeida; Paulo Fonseca; Ana Mosalina Manuel; Francisco Ramires; Paulo Santos Ferreira; Martim Sousa; Marco Oliveira; Helena Gonçalves; João Primo; Ricardo Fontes-Carvalho

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Atrial fibrillation (AF) carries significant burden in health expenditure worldwide. Digital health technology may improve healthcare delivery, but its applicability in clinical practice and related outcomes remain a gap in evidence. </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> To report the implementation of a digital follow-up program (FUP) for patients (pts) submitted to AF ablation in a Portuguese center.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A digital FUP was implemented at a high-volume ablation center in 2020. The program featured: a web platform for professionals to record Clinician Reported Outcome Measurements (CROMs), during remote medical visits, and access Patient Reported Outcomes Measurements (PROMs); and an app for pts to report symptoms, vital signs, anthropometric and electrocardiographic data, and to complete questionnaires (AFEQT, Epworth, STOP-BANG, nutritional). Completeness rate was defined by the ratio of queries completed/queries sent at each timepoint.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">The mHealth App Usability Questionnaire (MAUQ) questionnaire was sent to pts and doctors; pts also received a Patient Reported Experience Measure (PREMs) 15 days after the ablation, from which a Net Promotor Score (NPS, -100 to 100) was calculated to express user&rsquo;s satisfaction.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">This retrospective analysis includes data collected from December 2020 to September 2022. </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong> </strong></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">From the 305 ablations performed, 253 pts were enrolled in the digital FUP: age 60&plusmn;11 years, 67% male, 78% paroxysmal AF, body mass index 27.4&plusmn;4.2 kg/m2. </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">During a mean follow-up time of 11.9&plusmn;5.8 months, 1120 CROMs were registered; 1449 PROMs were collected, including 5865 metrics reported by 90 different pts. App usage, measured by unique logins/month, was recorded in 54% of pts, of whom 13% submitted symptom checks weekly.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">160 PREMs were registered; NPS scores for ablation and the app were 85.5 and 31.5, respectively [image]. </span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Questionnaires&rsquo; overall completeness rate was: 54.5% for AFEQT, 14.4% for Epworth; and 20.8% for STOP-BANG, that identified 55% of pts at high risk for sleep apnea. Nutritional assessment was completed by 18.7%; obese/pre-obese status was found in 21% and 48%, respectively; 18 pts were enrolled in a nutritional program.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">All doctors &ldquo;agreed&rdquo;/&ldquo;strongly agreed&rdquo; to overall satisfaction with the app.</span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions</strong>: The digital FUP was feasible and aided comorbidities assessment. Strategies to improve patient&rsquo;s engagement and digital literacy are warranted. Further studies are needed to evaluate the platform&rsquo;s impact on clinical outcomes.</span></span></p>