Prevention of depression in patients with atrial fibrillation using an online personalized intervention: the HOPE-AF feasibility study

AIM: The overall aim of this study was to examine the feasibility of a personalized online psychological intervention targeting prevention of depression in patients with atrial fibrillation. Specific objectives were to assess acceptability and adherence to the intervention and explore limited efficacy on patient-reported outcomes. METHODS AND RESULTS: We used a mixed-methods design containing descriptive statistics and ten semi-structured interviews. Participants consisted of 13 women and 15 men and had a mean age of 62 years (range: 26-86). Regarding acceptability, the primary outcome was drop-out, and we found a drop-out rate of 7% among the participating patients (2/28). Completed patients were fully adherent to their personalized planned intervention. For patient-reported outcomes, all mean measures on mental health and health-related quality of life were improved post-intervention. This included depression as measured with the Hospital Anxiety and Depression Scale. From thematic analysis on the interviews, we generated four themes consisting of: Meaningful content; Communication; Technicalities; and Personal gain. Overall, patients perceived their personalized intervention relevant for their individual situation, they felt engaged in planning of their intervention and that online treatment allowed a high level of autonomy. Patients felt empowered and experienced that the acquired psychological tools were useful in everyday life with atrial fibrillation. CONCLUSION: This feasibility study demonstrated a low drop-out rate and high adherence to the intervention. Completion of intervention was associated with potentially improved mental health. The findings support a future randomized controlled trial to evaluate clinical and cost effectiveness of the intervention.