Patient motivation and adherence to an on-demand app-based heart rate and rhythm monitoring for atrial fibrillation management: data from the TeleCheck-AF project

Monika Gawałko, Astrid Nl Hermans, Rachel Mj van der Velden, Konstanze Betz, Dominique Vm Verhaert, Henrike Ak Hillmann, Daniel Scherr, Julia Meier, Arian Sultan, Daniel Steven, Elena Terentieva, Ron Pisters, Martin Hemels, Leonard Voorhout, Piotr Lodziński, Bartosz Krzowski, Dhiraj Gupta, Nikola Kozhuharov, Laurent Pison, Henri GruwezLien Desteghe, Hein Heidbuchel, Stijn Evens, Emma Svennberg, Tom de Potter, Kevin Vernooy, Nikki Aha Pluymaekers, Martin Manninger, David Duncker, Afzal Sohaib, Dominik Linz*, Jeroen M Hendriks

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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AIMS: The aim of this TeleCheck-AF sub-analysis was to evaluate motivation and adherence to on-demand heart rate/rhythm monitoring app in patients with atrial fibrillation (AF).

METHODS AND RESULTS: Patients were instructed to perform 60 s app-based heart rate/rhythm recordings 3 times daily and in case of symptoms for 7 consecutive days prior to teleconsultation. Motivation was defined as number of days in which the expected number of measurements (≥3/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period.Data from 990 consecutive patients with diagnosed AF [median age 64 (57-71) years, 39% female] from 10 centres were analyzed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 28% of the study population and had a lower percentage of recordings in sinus rhythm [90 (53-100%) vs. 100 (64-100%), P < 0.001] compared with others. Older age and absence of diabetes were predictors of both optimal motivation and adherence [odds ratio (OR) 1.02, 95% coincidence interval (95% CI): 1.01-1.04, P < 0.001 and OR: 0.49, 95% CI: 0.28-0.86, P = 0.013, respectively]. Patients with 100% motivation also had ≥100% adherence. Independent predictors for optimal adherence alone were older age (OR: 1.02, 95% CI: 1.00-1.04, P = 0.014), female sex (OR: 1.70, 95% CI: 1.29-2.23, P < 0.001), previous AF ablation (OR: 1.35, 95% CI: 1.03-1.07, P = 0.028).

CONCLUSION: In the TeleCheck-AF project, more than one-fourth of patients had optimal motivation and adherence to app-based heart rate/rhythm monitoring. Older age and absence of diabetes were predictors of optimal motivation/adherence.

Original languageEnglish
Number of pages13
JournalEuropean Journal of Cardiovascular Nursing
Publication statusE-pub ahead of print - 6 Aug 2022


  • Atrial fibrillation
  • Mobile health
  • Photoplethysmography
  • Risk factors
  • Thromboembolic risk

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