210The impact of an online directed education platform on the knowledge level of atrial fibrillation patients undergoing cardioversion or pulmonary vein isolation

Abstract

Background: Educating atrial fibrillation (AF) patients is an important aspect to optimise their care, allowing shared decision making. Little is known about the knowledge of AF patients concerning direct current cardioversion (DCC) or pulmonary vein isolation (PVI). Most hospitals do not have structured educational programs to improve patients' knowledge. Purpose: The aim of this study was to investigate the effect of online directed education on AF-related and procedure-related knowledge in AF patients. Methods: Patients planned to undergo a DCC or PVI procedure and having a computer/tablet/smartphone, were recruited for this study. Patients were stratified and randomised to an intervention group (receiving directed online education n=35) or a control group (receiving standard care with information from brochures and/or directly from cardiologists n=36). Included patients had to complete the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) at different time points: 1-3 weeks pre-procedurally (P) during their hospitalisation (H) and 6 and 12 weeks post-procedurally. For this study, the JAKQ was supplemented with 4 procedure-specific questions about DCC or PVI. A patient reported outcome measures questionnaire was used to evaluate patients' experience with the online platform. Results: The 66 patients (25 DCC and 41 PVI 32 control and 34 online education) who completed the entire follow-up had a mean age of 6469 years. Major knowledge gaps were found at baseline: barely 35.7% knew that AF can reoccur after a DCC; only 28.6% knew that it is allowed to perform a DCC multiple times about half of the PVI patients (58.1%) knew that the success rate of their procedure was about 70%; and hardly 32.6% knew that PVI procedures carry a risk for major complications of around 1%. The score on the JAKQ and on the procedure-related questions was not significantly different between the control and the education group at baseline (68.6615.3% vs 70.8612.0% p=0.740) respectively (43.8628.4% vs 52.9625.2%; p=0.109). The intervention group scored significantly better on the JAKQ at hospitalisation (77.6612.5%, p=0.045) and this knowledge increase was still present three months after the procedure (79.6610.7%, p=0.01). There was a similar knowledge increase for the PVI or DCC specific questions (see Figure). In the control group, there was a significant increase in the score on the JAKQ 6 weeks after the procedure compared to hospitalisation (63.7616.9% vs 73.2613.7%, p=0.026). Most patients indicated that the platform was easy to use (87.9%), understandable (97.0%) and contained a good amount of information (87.9%). 72.7% indicated that an online platform was the preferred way to receive AF information. Conclusion: AF patients underestimate the risks associated with rhythm restoring procedures and overestimate the success rates of these treatments. Online directed education significantly improved patients' AF-related and procedure-related knowledge.