Mehawej Jordy, Mishra Ajay, Saczynski Jane S, Waring Molly E, Lessard Darleen, Abu Hawa O, La Vincent, Tisminetzky Mayra, Tran Khanh-Van, Hariri Essa, Filippaios Andreas, Paul Tenes, Soni Apurv, Wang Weijia, Ding Eric Y, Bamgbade Benita A, Mathew Joanne, Kiefe Catarina, Goldberg Robert J, McManus David D
Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts.
Cardiovasc Digit Health J. 2022 Mar 11;3(3):118-125. doi: 10.1016/j.cvdhj.2022.03.001. eCollection 2022 Jun.
Little is known about online health information-seeking behavior among older adults with atrial fibrillation (AF) and its association with self-reported outcomes.
To examine patient characteristics associated with online health information seeking and the association between information seeking and low AF-related quality of life and high perceived efficacy in patient-physician interaction.
We used data from the SAGE-AF (Systematic Assessment of Geriatric Elements in AF) study, which includes older participants aged ≥65 years with AF and a CHADS-VASc risk score ≥2. To assess online health information seeking, participants who reported using the Internet were asked at baseline if they used the Internet to search for advice or information about their health in the past 4 weeks (not at all vs at least once). Atrial Fibrillation Effect on Quality of Life and Perceived Efficacy in Patient-Physician Interactions questionnaires were used to examine AF-related quality of life (QOL) and patient-reported confidence in physicians. Logistic regression models were used to examine demographic and clinical factors associated with online health information seeking and associations between information seeking and low AF-related QOL (AFEQT <80) and high perceived efficacy for patient-physician interactions (PEPPI ≥45).
A total of 874 online participants (mean age 74.5 years, 51% male, 91% non-Hispanic White) were studied. Approximately 60% of participants sought health information online. Participants aged 74 years or older and those on anticoagulation were less likely, while those with a college degree were more likely, to seek online health information after adjusting for potential confounders. Participants who sought health information online, compared to those who did not, were significantly more likely to have a low AF-related QOL, but less likely to self-report confidence in patient-physician interaction (aOR = 1.56, 95% CI: 1.15-2.13; aOR = 0.68, 95% CI: 0.49-0.93, respectively).
Clinicians should consider barriers to patient-physician interaction in older adults who seek health information online, encourage shared decision-making, and provide patients with a list of online resources for AF in addition to disease education plans to help patients manage their health.
关于老年房颤患者的在线健康信息搜索行为及其与自我报告结果之间的关联，目前所知甚少。
研究与在线健康信息搜索相关的患者特征，以及信息搜索与低房颤相关生活质量和高医患互动感知效能之间的关联。
我们使用了SAGE-AF（房颤老年因素系统评估）研究的数据，该研究纳入了年龄≥65岁、CHADS-VASc风险评分≥2的房颤老年参与者。为了评估在线健康信息搜索情况，在基线时询问报告使用互联网的参与者在过去4周内是否使用互联网搜索过有关其健康的建议或信息（从未使用过与至少使用过一次）。使用房颤对生活质量和医患互动感知效能问卷来评估房颤相关生活质量（QOL）和患者报告的对医生的信心。使用逻辑回归模型来研究与在线健康信息搜索相关的人口统计学和临床因素，以及信息搜索与低房颤相关QOL（AFEQT<80）和高医患互动感知效能（PEPPI≥45）之间的关联。
共研究了874名在线参与者（平均年龄74.5岁，51%为男性，91%为非西班牙裔白人）。约60%的参与者在线搜索健康信息。在调整潜在混杂因素后，74岁及以上的参与者和接受抗凝治疗的参与者在线搜索健康信息的可能性较小，而具有大学学历的参与者可能性较大。与未在线搜索健康信息的参与者相比，在线搜索健康信息的参与者房颤相关生活质量较低的可能性显著更高，但自我报告对医患互动有信心的可能性较小（调整后比值比分别为1.56，95%置信区间：1.15-2.13；0.68，95%置信区间：0.49-0.93）。
临床医生应考虑在线搜索健康信息的老年患者在医患互动方面的障碍，鼓励共同决策，并除了疾病教育计划外，为患者提供房颤在线资源列表，以帮助患者管理自身健康。
