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Patients’ Experiences with Cardiac Monitors for Stroke, Atrial Fibrillation, and Heart Failure: A Rapid Qualitative Review

Last updated: September 17, 2018
Project Number: RC1019-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. How do patients experience, make decisions around, and live with outpatient cardiac monitors for the diagnosis of stroke, atrial fibrillation, and/or heart failure?

Key Message

The onset of cardiac monitor use accompanies many life changes and new personal responsibilities. For some patients, these responsibilities can spur motivation to engage in self-management and health care decision-making. For other patients, new responsibilities can create confusion and uncertainty about how to use their device and communicate with care providers about cardiac self-management. Embedded in these experiences are patients’ expressions of uncertainty and the need for more accurate and timely information about the cardiac monitoring process. Although patients participating in the included studies mentioned more positive than negative experiences to using cardiac monitors, negative experiences were described that  stem from uncertainty in how to use the device,  treatment options while using a cardiac monitor, available community supports, and the perceived accuracy and reliability of cardiac monitors. As patients engaged with cardiac monitors over time, the benefits to using cardiac devices outweighed the disadvantages. Providing information on cardiac self-management and using monitoring devices may support patients’ ongoing reflection and understanding of their cardiac condition. Information that is provided in a timely and appropriate manner may motivate patients to engage in their own health care decision-making, which they perceived as a central component to maintaining self-management behaviours. However, patients experienced multiple barriers to using the device, many of which were due to their technological proficiency and unique social location. These patients requested additional support either through the system or in-person to use the device. When such support was provided, patients felt relief, reassurance, and confidence, which enabled them to integrate cardiac monitoring into their daily routine.