The Future Patient Telerehabilitation Program for Patients with Atrial Fibrillation: A Qualitative Study of Patients’ Perspectives (Preprint)

BACKGROUND Atrial fibrillation (AF) is a prevalent chronic condition with increasing incidence worldwide. AF increases the risks of stroke, heart failure, and myocardial infarction and imposes a substantial burden on the healthcare system. Cardiac rehabilitation programs, while effective, often suffer from low patient adherence. Recent evidence suggests that cardiac telerehabilitation, where patients are given home monitoring devices, could enhance adherence and outcomes. The program ‘Future Patient – Telerehabilitation of patients with AF’ (FP-AF) was created to assess the effects and potential benefits of cardiac telerehabilitation on AF patients. This study explores patient experiences with the FP-AF program. OBJECTIVE To explore the experiences of patients participating in the FP-AF program. METHODS This qualitative sub-study is part of the multicenter, randomized controlled FP-AF trial, which included 208 patients. Semi-structured interviews were conducted on 14 patients, randomly selected from participants in the intervention arm of the FP-AF program. The patient interviews, guided by self-determination theory, focused on patients' experiences with the FP-AF program, including the use of telerehabilitation technologies and an interactive web portal called the ‘HeartPortal’. Interview responses were analyzed using NVivo software, with thematic coding based on interview guides and methodological guidance elaborated by Brinkmann & Kvale. The study adhered to ethical guidelines, with informed consent obtained from all participants. RESULTS Based on the interviews, the following themes were identified: The home monitoring devices are viewed positively by the patients, the HeartPortal is a useful digital toolbox, patients develop new coping strategies for living with AF, the measured values are useful for the patients, the community of practice is beneficial, the FP-AF program creates a sense of security. CONCLUSIONS Patients’ participation in the FP-AF program enhanced their sense of security, empowerment, and knowledge about AF. This improvement was largely due to a combination of patients’ use of the HeartPortal and the educational sessions held at the healthcare centers. Telerehabilitation for patients with AF has the potential to be an effective means of offering rehabilitation to this group in the future. CLINICALTRIAL The FP-AF study is listed in ClinicalTrials.gov (NCT06101485) INTERNATIONAL REGISTERED REPORT RR2-10.2196/64259