A consumer co-designed, self-delivered, Avatar-based patient discharge education application improves acute coronary syndrome (ACS) patient knowledge

Abstract

Title: A consumer-co-designed, self-delivered, Avatar-based patient discharge education application improves acute coronary syndrome (ACS) patient knowledge

Background: High 30-day rehospitalisation rates among ACS patients have been attributed to poor disease knowledge and self-care, especially in those with low literacy and health literacy. Traditional patient education methods fail to address these issues.

Aims: We aimed to develop and evaluate a consumer-co-designed discharge education application (app) and test its effectiveness on disease knowledge and acceptability.

Methods: Based on the Heart Foundation Six Steps to Cardiac Recovery the app underwent a rigorous development process with the substantial engagement of consumers (Figure 1). It was piloted in patients with unstable angina or a non-STEMI episode. Disease knowledge, ACS responses were assessed at baseline, followed by first use and one month later. Patients and cardiac nurses rated the acceptability.

Results: Among 22 participants; 81.8% were male, mean age 59.7 years; 45.5% had not completed high school and 25% had marginal health literacy.

Significant improvements were observed for overall disease knowledge at one month (p=.003) and for the exercise and nutrition domains at discharge (p=.029; p<.001) and one month (p=.02; p=.003) (Figure 2). Significant improvements were also observed for ACS knowledge and beliefs at discharge (p=.008; p=.038) and one month (p<.001; p=.025) when ACS response attitude was also significantly improved at one month (p=.036). The app had very high acceptability, and was described as ‘clear, simple, easy to understand, stimulating and interactive, better than a live person’.

Conclusions: This novel ACS education app has the potential to provide discharge education for ACS patients even for patients with low education and health literacy.