Co-Designing a Digital Platform for the Management of Modifiable Risk Factors and Comorbidities in Patients With Atrial Fibrillation: Mixed Methods Usability Study.

BACKGROUND

Clinical guidelines recommend integrated, person-centered care with control of modifiable risk factors and coexisting conditions in patients with atrial fibrillation (AF), but many receive insufficient risk factor management. Digital health technologies may provide valuable support in addressing this gap.

OBJECTIVE

Our aim was to evaluate the usability of a co-designed digital platform for supporting person-centered management of modifiable risk factors in individuals with AF.

METHODS

This mixed methods usability study was conducted at a tertiary university hospital in Sweden between March and April 2025. Eligible participants with AF were recruited to evaluate the co-designed digital platform using the System Usability Scale (SUS) and semistructured interviews analyzed with inductive manifest content analysis.

RESULTS

A total of 22 patients were included (mean age 67.7, SD 7.6 y); 32% (7/22) were female, the mean BMI was 27.7 (SD 3.6) kg/m2, 65% (14/22) had paroxysmal AF, 36% (8/22) had persistent AF, and the median AF duration was 26 (IQR 13.3-72.8) months. Relevant comorbidities were hypertension (17/22, 77%), heart failure (8/22, 36%), diabetes mellitus type 2 (3/22, 14%), and ischemic heart disease (4/22, 18%). Usability was rated high, with a median SUS score of 78.8 (IQR 63.8-86.9), indicating above-average user acceptance. Participants' requirements were summarized into 4 main categories and 10 subcategories. First, they valued a clear layout, simple design, and easy navigation. Second, they appreciated positive content, which is informative, inclusive, and motivating. Third, they requested personalized information on different aspects and provided on different levels. Fourth, they desired individualized medical recommendations that are personalized and flexible but open to individual choice.

CONCLUSIONS

Participants found the usability acceptable and valued specifically a clear layout, positive content, personalized information, and individualized medical recommendations.