Abstract P045: Self-reported Anxiety And Patient Activation Among Smartwatch Users Monitored For Atrial Fibrillation Post-stroke: The Pulsewatch Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2022-03, Vol.145 (Suppl_1)
• Main Authors: Paul, Tenes J, Tran, Khanh-van T, Mehawej, Jordy, Lessard, Darleen, Filippaios, Andreas, Ding, Eric, Joshi, Shiksha, Mensah Otabil, Edith, Noorishirazi, Kamran, Naeem, Syed, Soni, Apurv, Saczynski, Jane, McManus, David D
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.145.suppl_1.P045

Abstract only Introduction: Wearable devices such as smartwatches are emerging as convenient and accurate means of post-stroke atrial fibrillation (AF) detection, however little is known about how the use of smartwatches for this purpose affects patients’ anxiety or engagement with their medical care. Hypothesis: Use of a smartwatch for atrial fibrillation monitoring will not significantly increase anxiety or affect engagement with medical care in post-stroke patients. Methods: We analyzed data from a randomized controlled trial, the Pulsewatch study, which included patients (>=50 years) who presented to the UMass Memorial Health system with an ischemic stroke in the past decade, and/or had a CHA2DS2-VASc score >2, with no contraindications to anticoagulation. Participants were randomized to either wear a Samsung smartwatch for AF monitoring (intervention) or not wear a smartwatch (control) for 30 days. Participants completed the General Anxiety Disorder-7 (GAD7) and the Consumer Health Activation Index (CHAI), which examined anxiety and patient activation (i.e. personal healthcare knowledge and management ability), prior to and after the 30-day period. Logistic regression was used to examine the association between smartwatch use and changes in anxiety and patient activation before and after the 30-day period. Results: Participants in the control group (N=56) had a mean age of 66, were 43% female, and 88% white, compared to the intervention group (N=54) which had a mean age of 64, were 41% female, and 91% white. There were no significant differences in baseline levels of anxiety (control 15% vs intervention 20%, P=0.3) and patient activation (control 12% vs intervention 10%, P=0.7) between the groups. After 30 days of rhythm monitoring, smartwatch users, as opposed to participants without a smartwatch, did not have a higher odd of having increased anxiety (38.9% vs 29.1%; aOR 1.37; 95% CI 0.45-4.15) or patient activation (20.4% vs 35.7%; aOR 0.62; 95% CI 0.18-2.17), adjusting for baseline anxiety, patient activation, valvular disease, diabetes, beta blocker use, and anticoagulant use. Conclusion: To the best of our knowledge, this is among the first studies to demonstrate a lack of difference in anxiety or patient activation in older stroke survivors who were prescribed a smartwatch for AF monitoring as compared to controls. Further studies are needed to elucidate the benefits and pitfalls related to the use of wearables as an alternative for post-stroke