Abstract

Introduction: Early detection of AF is critical for stroke prevention. Several commercially available smartwatches are FDA cleared for AF detection; however, little is known about how use of a smartwatch impacts patient-physician relationships or patient anxiety, patient activation, and patient health-related quality of life. Hypothesis: Low self-reported efficacy in patient-physician interaction is associated with worse patient activation, increased anxiety, and lower self-rated quality of life. Methods: Data were used from the Pulsewatch study, a two-phased randomized controlled trial, which enrolled adults (>50 years of age) with no contraindication to anticoagulation. The Perceived Efficacy in Patient-Physician Interactions (PEPPI) was used to assess patient confidence in physician interaction at baseline. Generalized Anxiety Disorder-7 Scale, Consumer Health Activation Index, and Short-Form Health Survey were utilized to examine anxiety, patient activation, and physical and mental health status, at baseline, 14, and 44 days, respectively. We used a mixed-effects repeated measures linear regression models to assess changes in anxiety, patient activation, and physical and mental health status in relation to self-reported efficacy in physician interaction, adjusting for confounding variables, over the study period. Results: A total of 93 participants (average age 64.1 ± 8.9 years; 43.0% female; 88.2% non-Hispanic white) were included in this analysis. 60% (n=56) of participants reported high perceived efficacy in patient-physician interaction. In the fully adjusted models, high perceived efficacy, vs low, was associated with an increased patient activation and mental health status (β 12.0, p-value <0.001; β 3.39, p-value <0.05, respectively), but was not associated with anxiety or physical health status (β -0.61, p-value 0.46; β 0.64, p-value 0.77). Conclusions: Our observation that higher self-efficacy leads to improved patient activation and mental health among stroke survivors suggest that self-efficacy is an important psychosocial marker. Efforts to improve perceived efficacy in patient-physician interaction in may lead to better clinical outcomes.

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