Technology Readiness Level and Self-Reported Health in Recipients of an Implantable Cardioverter Defibrillator: Cross-Sectional Study.

Abstract

Background: Approximately 200,000 implantable cardioverter defibrillators (ICDs) are implanted annually worldwide, with around 20% of recipients experiencing significant psychological distress. Despite this, there are no ICD guidelines addressing mental health as part of rehabilitation programs, which primarily focus on educating patients about their condition and prognosis. There is a need to include elements such as emotional distress, social interactions, and the future use of technologies like apps and virtual communication in ICD rehabilitation, without increasing the burden on health care professionals.

Objective: This study aimed to demonstrate how data from the Readiness for Health Technology Index (READHY), combined with sociodemographic characteristics and exploratory interviews, can be used to construct profiles of recipients of an ICD, describing their ability to manage their condition, their need for support, and their digital health literacy. This aims to enhance health care professionals' understanding of different patient archetypes, serving as guidance in delivering personalized services tailored to the needs, resources, and capabilities of individual recipients of ICDs.

Methods: Overall, 79 recipients of an ICD participated in a survey assessing technology readiness using the READHY. The survey also collected sociodemographic data such as age, sex, and educational level. Self-reported health was measured using a Likert scale. Cluster analysis categorized participants into profiles based on their READHY scores. Correlations between READHY scores and self-reported health were examined. In addition, qualitative interviews with representatives from different readiness profiles provided deeper insights.

Results: Four technology readiness profiles were found: (1) profile 1 (low digital health literacy, insufficient on 5 dimensions), (2) profile 2 (sufficient on all dimensions), (3) profile 3 (consistently sufficient readiness on all dimensions), and (4) profile 4 (insufficient readiness on 9 dimensions). Participants in profile 4, characterized by the lowest readiness levels, were significantly younger (P=.03) and had lower self-reported health (P<.001) than those in profile 3. A correlation analysis revealed that higher READHY scores were associated with better self-reported health across all dimensions. Qualitative interviews highlighted differences in self-management approaches and the experience of support between profiles, emphasizing the essential role of social support toward the rehabilitation journeys of recipients of an ICD. Two patient vignettes were created based on the characteristics from the highest and lowest profiles.

Conclusions: Using the READHY instrument to create patient profiles demonstrates how it can be used to make health care professionals aware of specific needs within the group of recipients of an ICD.