Short summary

HOPE-AF is designed to prevent depression in patients with atrial fibrillation (AF), as patients with AF have a greater risk of adverse patient- reported and clinical outcomes. We will (1) develop a therapist-assisted eHealth intervention using patient and public involvement (PPI) design that can be tailored to patients depression risk factors, (2) Assess the feasibility of the HOPE-AF intervention; (3) evaluate the clinical effectiveness and cost-effectiveness in a randomized controlled trial.

Rationale

Atrial fibrillation [AF] is the most common sustained cardiac arrhythmia with a prevalence of around 3% in adults. In Denmark alone, about 20,000 new patients are diagnosed each year. Age is the most common risk factor for AF. Given the ageing of the population, the prevalence of AF has increased threefold during the last 50 years [1] and is now a major public health challenge.

AF is a potentially debilitating disease. Patients are not only at increased risk of stroke and heart failure but tend to continuously focus on the body's signals and have difficulties accepting the disease. This is often paired with psychological reactions, such as excessive worry and anxiety, increasing the risk of withdrawal from social activities, which often leads to depression.

Hence, the aim of the study is to develop an intervention targeted to preventing depression in AF patients. The intervention will be delivered via a GDPR secure platform and will be tailored to patients' risk factors for depression using a precision medicine approach. The effectiveness and cost-effectiveness will be examined.

Description of the cohort

Patients with atrial fibrillation from 7 centers across Denmark: Odense University Hospital; Aarhus University Hospital; Aalborg University Hospital; Regionshospitalet Herning; Regionshospitalet Silkeborg; Sygehus Sønderjylland Aabenraa; Svendborg Municipality.

Data and biological material

Demografic, diagnosis, other relevant clinical variables collected from the patient journal, questionnaire data, data from the national registries.