Patient Perspectives on the “Future Patient” Telerehabilitation Program for Atrial Fibrillation: Qualitative Study

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Abstract
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 health care system. Cardiac rehabilitation programs, while effective, often have 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 patients with AF. Objective: The objective of this study is 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 a web-based portal called the “HeartPortal.” Interview responses were analyzed using NVivo software (version 14.0; QSR International), 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; and the FP-AF program creates a sense of security. Conclusions: Participation in the FP-AF program enhanced patients’ sense of security, empowerment, and knowledge about AF. This improvement was due largely to a combination of patients’ use of the HeartPortal and the educational sessions at health care centers. Telerehabilitation for patients with AF may be a useful way of researching this group of patients with a focus on rehabilitation and may be an effective means of offering rehabilitation to this group in the future.

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