UMMS Affiliation

Department of Population and Quantitative Health Sciences; Division of Hospital Medicine, Department of Medicine; Division of Cardiovascular Medicine, Department of Medicine

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Geriatrics | Health Information Technology | Health Services Administration | Health Services Research | Social Media


BACKGROUND: Online support groups for atrial fibrillation (AF) and apps to detect and manage AF exist, but the scientific literature does not describe which patients are interested in digital disease support.

OBJECTIVE: The objective of this study was to describe characteristics associated with Facebook use and interest in digital disease support among older patients with AF who used the internet.

METHODS: We used baseline data from the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF), a prospective cohort of older adults ( > /=65 years) with AF at high stroke risk. Participants self-reported demographics, clinical characteristics, and Facebook and technology use. Online patients (internet use in the past 4 weeks) were asked whether they would be interested in participating in an online support AF community. Mobile users (owns smartphone and/or tablet) were asked about interest in communicating with their health care team about their AF-related health using a secure app. Logistic regression models identified crude and multivariable predictors of Facebook use and interest in digital disease support.

RESULTS: Online patients (N=816) were aged 74.2 (SD 6.6) years, 47.8% (390/816) were female, and 91.1% (743/816) were non-Hispanic white. Roughly half (52.5%; 428/816) used Facebook. Facebook use was more common among women (adjusted odds ratio [aOR] 2.21, 95% CI 1.66-2.95) and patients with mild to severe depressive symptoms (aOR 1.50, 95% CI 1.08-2.10) and less common among patients aged > /=85 years (aOR 0.27, 95% CI 0.15-0.48). Forty percent (40.4%; 330/816) reported interest in an online AF patient community. Interest in an online AF patient community was more common among online patients with some college/trade school or Bachelors/graduate school (aOR 1.70, 95% CI 1.10-2.61 and aOR 1.82, 95% CI 1.13-2.92, respectively), obesity (aOR 1.65, 95% CI 1.08-2.52), online health information seeking at most weekly or multiple times per week (aOR 1.84, 95% CI 1.32-2.56 and aOR 2.78, 95% CI 1.86-4.16, respectively), and daily Facebook use (aOR 1.76, 95% CI 1.26-2.46). Among mobile users, 51.8% (324/626) reported interest in communicating with their health care team via a mobile app. Interest in app-mediated communication was less likely among women (aOR 0.48, 95% CI 0.34-0.68) and more common among online patients who had completed trade school/some college versus high school/General Educational Development (aOR 1.95, 95% CI 1.17-3.22), sought online health information at most weekly or multiple times per week (aOR 1.86, 95% CI 1.27-2.74 and aOR 2.24, 95% CI 1.39-3.62, respectively), and had health-related apps (aOR 3.92, 95% CI 2.62-5.86).

CONCLUSIONS: Among older adults with AF who use the internet, technology use and demographics are associated with interest in digital disease support. Clinics and health care providers may wish to encourage patients to join an existing online support community for AF and explore opportunities for app-mediated patient-provider communication.


atrial fibrillation, information seeking behavior, social media

Rights and Permissions

© Molly E. Waring, Mellanie T Hills, Darleen M. Lessard, Jane S. Saczynski, Brooke A. Libby, Marta M. Holovatska, Alok Kapoor, Catarina I. Kiefe, David D. McManus. Originally published in JMIR Cardio (, 11.11.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.

DOI of Published Version



JMIR Cardio. 2019 Nov 14;3(2):e15320. doi: 10.2196/15320. Link to article on publisher's site

Journal/Book/Conference Title

JMIR cardio

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.