Abstract P046: Psychosocial Measures In Relation To Smartwatch Device Alerts For Atrial Fibrillation Detection Post Stroke: The Pulsewatch Study

Abstract

Background: Atrial fibrillation (AF) is a major stroke risk factor and rhythm monitoring post stroke is recommended. Wearable smartwatches with different device alert systems have been increasingly popular. Anxiety and perceived confidence in physicians, particularly in older stroke survivors, in relation to alerts delivered from AF detection devices remain to be elucidated. Objectives: Assess the associations between smartwatch alerts for detected atrial fibrillation in older post stroke patients and self-reported anxiety and perceived confidence in physicians. Methods: Data were used from Phase I of the Pulsewatch study, a randomized controlled trial, which enrolled patients (≥50 years) from the UMass Memorial Health System with a history of a stroke or transient ischemic attack (TIA), CHA 2 DS 2 -VASc ≥ 2 and no contraindications to anticoagulation. Intervention participants wore a cardiac patch monitor, a smartwatch, and were given a smartphone installed with the Pulsewatch applications, while control participants only wore the cardiac patch monitor for 14 days. Intervention participants were grouped into those receiving at least one alert versus those who did not receive any alerts from the smartwatch. Generalized Anxiety Disorder-7 Scale and Perceived Efficacy in Patient-Physician Interactions Questionnaire were utilized at baseline and 14 days to assess anxiety and perceived confidence in physicians, respectively. Logistic regression was used to examine anxiety and perceived confidence in physicians in relation to alerts amongst smartwatch users. Results: A total of 68 participants (on average 65.2 ± 9.2 years of age, 41.2% [28 of 68] were women, 83.8% [57 of 68] were non-Hispanic white) were included in the intervention arm; 10 of which received at least one alert. Reception of alerts was not significantly associated with increased anxiety (adjusted OR [aOR] 0.98, 95% CI 0.13 - 7.6) or decreased perceived confidence in physicians (aOR 1.86, 95% CI 0.26 - 13.4), adjusting for the corresponding baseline outcome. Conclusions: Our study shows that smartwatch devices prescribed for AF detection in stroke survivors are not significantly associated with increased anxiety or decreased perceived confidence in physicians. Further studies are needed to explore their potential as methods for AF monitoring in older patients post stroke.