Evaluating patient attitudes and barriers towards smart technology for cardiac monitoring: Results from a prospective multicentre study

Anoop N. Koshy, Jefferson Ko, Jithin K. Sajeev, Kevin Rajakariar, Louise Roberts, Jennifer Cooke, Andrew W. Teh

Research output: Contribution to journalArticleResearchpeer-review


Objectives: Remote assessment of heart rate and rhythm using smart technology (ST) holds promise in screening and monitoring of atrial fibrillation (AF). However, patient engagement is paramount to the success of ST interventions. Methods: We assessed the attitudes and potential barriers towards ST for arrhythmia monitoring in an elderly, multimorbidity cohort. Consecutive inpatients were recruited across three hospitals and administered a standardised survey regarding attitudes towards ST for arrhythmia detection. Results: Of 363 participants (median age 68 years (IQR: 55-80 years), mean CHA2DS2VASC score 3±2), 68.9% were interested in ST for cardiac monitoring. Those with underlying AF (n=112) and younger (<65 years) patients were more likely to be interested in using ST for cardiac monitoring (p for both <0.001). Complexity (71.1%) of ST was identified as a major barrier to its adoption, particularly in older participants (p=0.02). While only 52% of participants trusted the accuracy of ST, over 90% would seek medical attention based on aberrant readings. Conclusion: We report a high level of interest among an older, high-risk patient cohort in using ST for cardiac monitoring. Despite a level of distrust in these devices, abnormal readings would still prompt the overwhelming majority of patients to seek medical attention. This highlights a need for physicians to validate the accuracy and clinical effectiveness of ST-derived physiological measurements, an area which remains unclear due to the paucity of trials. Trial registration number: ACTRN: 12616991374459.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalBMJ Innovations
Issue number2-3
Publication statusAccepted/In press - 30 Dec 2019


  • atrial fibrillation
  • mobile health
  • patient attitudes
  • smart watch
  • smartphone
  • survey

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