{"doi":"10.1016/j.cvdhj.2023.04.002","title":"Anxiety, patient activation, and quality of life among stroke survivors prescribed smartwatches for atrial fibrillation monitoring","abstract":"Background: The detection of atrial fibrillation (AF) in stroke survivors is critical to decreasing the risk of recurrent stroke. Smartwatches have emerged as a convenient and accurate means of AF diagnosis; however, the impact on critical patient-reported outcomes, including anxiety, engagement, and quality of life, remains ill defined. Objectives: To examine the association between smartwatch prescription for AF detection and the patient-reported outcomes of anxiety, patient activation, and self-reported health. Methods: We used data from the Pulsewatch trial, a 2-phase randomized controlled trial that included participants aged 50 years or older with a history of ischemic stroke. Participants were randomized to use either a proprietary smartphone-smartwatch app for 30 days of AF monitoring or no cardiac rhythm monitoring. Validated surveys were deployed before and after the 30-day study period to assess anxiety, patient activation, and self-rated physical and mental health. Logistic regression and generalized estimation equations were used to examine the association between smartwatch prescription for AF monitoring and changes in the patient-reported outcomes. Results: A total of 110 participants (mean age 64 years, 41% female, 91% non-Hispanic White) were studied. Seventy percent of intervention participants were novice smartwatch users, as opposed to 84% of controls, and there was no significant difference in baseline rates of anxiety, activation, or self-rated health between the 2 groups. The incidence of new AF among smartwatch users was 6%. Participants who were prescribed smartwatches did not have a statistically significant change in anxiety, activation, or self-reported health as compared to those who were not prescribed smartwatches. The results held even after removing participants who received an AF alert on the watch. Conclusion: The prescription of smartwatches to stroke survivors for AF monitoring does not adversely affect key patient-reported outcomes. Further research is needed to better inform the successful deployment of smartwatches in clinical practice.","journal":"Cardiovascular Digital Health Journal","year":2023,"id":366946,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9537,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":417370,"name":"Khanh‐Van Tran","orcid":"0000-0002-7036-2969","position":1,"is_corresponding":false},{"id":740859,"name":"Jordy Mehawej","orcid":"0000-0001-6877-6778","position":2,"is_corresponding":false},{"id":338817,"name":"Darleen Lessard","orcid":"0000-0002-9644-2203","position":3,"is_corresponding":false},{"id":306785,"name":"Eric Ding","orcid":"0000-0002-6904-8534","position":4,"is_corresponding":false},{"id":965031,"name":"Andreas Filippaios","orcid":"0000-0003-0082-5507","position":5,"is_corresponding":false},{"id":981563,"name":"Sakeina Howard-Wilson","orcid":"0000-0002-7986-0585","position":6,"is_corresponding":false},{"id":919784,"name":"Edith Mensah Otabil","orcid":"0000-0002-8926-8403","position":7,"is_corresponding":false},{"id":944469,"name":"Kamran Noorishirazi","orcid":"0000-0002-4059-2771","position":8,"is_corresponding":false},{"id":915510,"name":"Syed Naeem","orcid":"0000-0001-8851-8477","position":9,"is_corresponding":false},{"id":1049414,"name":"Alexander Hamel","orcid":"0000-0002-5855-6912","position":10,"is_corresponding":false},{"id":320317,"name":"Dong Han","orcid":"0000-0001-7872-7371","position":11,"is_corresponding":false},{"id":306788,"name":"Ki H. Chon","orcid":"0000-0002-4422-4837","position":12,"is_corresponding":false},{"id":417373,"name":"Bruce Barton","orcid":"0000-0001-7878-8895","position":13,"is_corresponding":false},{"id":338820,"name":"Jane S. Saczynski","orcid":"0000-0002-6411-4774","position":14,"is_corresponding":false},{"id":306787,"name":"David D. McManus","orcid":"0000-0002-9343-6203","position":15,"is_corresponding":false},{"id":965032,"name":"Tenes Paul","orcid":"0000-0002-0135-6864","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T01:14:59.372548Z","pmid":"37600446","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}