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Patient Education About Aortic Stenosis? There's an App for That!
Medtronic Has Created an iPad App for Nurses, Patients, and Caregivers to Help Educate About Treatment Options for Aortic Stenosis
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picture of Aortic Stenosis Patient Journey iPad App
Aortic Stenosis Patient Journey iPad App
January 25, 2016 -- The treatment for aortic stenosis that has progressed to a critical and life-threatening narrowing is replacement of the aortic valve. Until relatively recently, this condition has been treated with open surgery (SAVR or surgical aortic valve replacement), a procedure which the patient must be healthy enough to withstand.

With the introduction and ongoing refinement of transcatheter aortic valve replacement (TAVR), patients who previously were not eligible for valve replacement can now be treated with percutaneous placement (non-surgical) of an aortic valve. Studies are ongoing for intermediate patients who could be treated surgically, but may prefer the non-surgical method. Moreover, there are a variety of devices on the market; in the U.S. both Edwards (Sapien) and Medtronic (CoreValve) devices are approved by the FDA.

But the existence of these options can be confusing for the patient so, when diagnosed with aortic stenosis, it is important that the patient, his/her family and caregiver understand what aortic stenosis is, and how it can be treated.

To address this need, Medtronic, manufacturer of both surgical and percutaneous valves, has developed an easy-to-use iPad app, explaining the disease, its treatment options and, importantly, what happens after discharge from the hospital, when the level of care is reduced and additional support becomes very important. Dubbed the "Aortic Stenosis Patient Journey iPad App," nursing staff, as well as patients and their family, can download this tool from the iTunes store for free.

The app, developed by Medtronic in collaboration with an advisory board of nurses (valve clinic coordinators) to address the educational needs of this challenging patient population, has received the Seal of Recognition from the Association of periOperative Registered Nurses for meeting the standards of excellence in safe patient care.

There are a number of aspects that make patient education for this procedure challenging:

  1. The average patient is 80 years-old;
  2. The disease involves a complex screening and treatment process;
  3. Nurses often need to educate multiple family members over multiple visits.
Susie Page, RN
Susie Page, RN

Valve clinic coordinator Susie Page, RN, from the University of Kansas Medical Center in Kansas City, KS, has been using this iPad app and discussed her experience with Angioplasty.Org.

Q: In your experience, who uses this app tool most: nursing staff, family or other caregivers, or the patients themselves?
Page: In my experience it has been the nursing staff who use the app tool to educate the patients. I set it up to run whatever the patient needs to see or wants to see and then it is viewed with either me or the staff, allowing for questions or interactions while it plays. I have used the app tool numerous times also to educate staff. It is extremely useful to show a new staff member, or someone new to TAVR, how the procedure works in a short period of time. Being on the mobile iPad platform, it goes where I go in the hospital. I can give an “on the spot” in service to either staff or patients with no notice at all.

Q: Since most patients having this type of procedure are of an advanced age (70+), are they able to use an iPad to view it?
Page: Yes, most patients are older. Some are quite tech savvy and some not. Same with family members. I think, as with any teaching modality, you must choose your audience. You must know what the need and what they want to know. Once the above assessment is made, I can then set up the app on the iPad that will benefit the patient/family/staff the most. I have yet to just leave the iPad in the room and let them surf around. There is just such a great opportunity for questions and answers that I feel a staff person should be present to add the human interaction, answering questions for the patient, not adding to their confusion and frustration. Nine times out of ten, I get a response of “Oh wow! Now I see how this will work!” Patients with a previously placed prosthetic valve love seeing how their current valve sits and where the CoreValve will go by using the 3D app. In contrast to just running a video, this is something they can actually “hold”, see, and maneuver, thereby allowing for education through multiple modalities at once without sensory overload. The patient, staff, and family are actively participating in the learning process and that helps with retention.

Q: What have you seen to be the biggest problems/challenges that SAVR or TAVR patients have, vis-a-vis the procedure and aftercare? And how does this app help in those areas?
Page: SAVR and TAVR patients recover very differently. They are two different operations. With SAVR there is the sternotomy to heal and therefore many more restrictions for a longer period of time. These patients require more help at home for a longer time due to the these physical restrictions, pain levels, longer hospital stay, etc. TAVR patients have none of the above. They are up and around a few hours after implant with little to know “outward” signs of their procedure.

What the app does is differentiate between the two. Many people in the populations who receive TAVR know someone, or they themselves, have been through the traditional SAVR. They come in anticipating the same process post TAVR. With the app, we can show the differences and therefore they understand why they will be back to their activities of daily living much, much sooner than the patient undergoing traditional SAVR. Because they have minimal physical wounds from the procedure to recover from, they will immediately start their recovery from their deconditioning that was present before their TAVR that was related to their aortic stenosis, heart failure, etc. They start out way ahead of the game!

The bottom line is that this app has become an important tool for me as a TAVR coordinator, not only for patients but for their families and our staff.

Below is a short video, supplied and produced by Medtronic, demonstrating the app.

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Aortic Stenosis Patient Journey iPad App

Reported by Burt Cohen, January 25, 2016