Digital health technologies for supporting patients with atrial fibrillation

Abstract

Atrial fibrillation (AF) management is complex and newer models of care delivery involving digital health are warranted to support patient self-management and address the growing disease burden. Conversational artificial intelligence (AI) is an interactive technology that can mimic human-like conversations and has the potential to provide personalised patient support but has not been previously explored in the context of AF. A cross-sectional observational survey and semi-structured interviews revealed that people with cardiovascular disease had difficulties in accessing healthcare, delayed seeking medical attention and struggled with engaging in healthy lifestyle behaviours during the COVID-19 pandemic in Australia. Additionally, a cross-sectional retrospective analysis of an Australian primary care dataset found more than one-third of AF patients with hypertension had poor blood pressure control. These findings indicate existing gaps in cardiovascular care. CHAT-AF, a post-discharge digital support intervention showed promising results in improving quality of life in patients with AF. The intervention leveraged a novel technology (conversational AI), that had not previously been evaluated in patients with AF, and found high satisfaction and engagement among users. Semi-structured interviews revealed acceptability of voice-based conversational AI for AF care was positive but the need for additional personalisation and improved dialogue flexibility was expressed by patients. Further large-scale RCTs and implementation studies are needed to determine the effectiveness of digital self-management interventions in AF, in supporting patients with AF and improving risk factor control, patient-reported measures and health outcomes.