Research Lien Desteghe

Abstract

Physical inactivity remains widespread and leads to considerable, yet largely preventable, mortality, morbidity, and healthcare costs. Physical activity is one of the most cost-effective and powerful "medicines" available, beneficial across a wide range of populations, from cardiac patients to individuals in oncological rehabilitation and primary care. However, reliable, objective, and personalized tools to monitor physical activity at home are still lacking, leaving both patients and healthcare professionals without actionable feedback. Our research group previously developed, in a cardiac rehabilitation context, an automated workflow around the Antwerp Activity Index (AAI), a heart rate-based activity score that translates the duration and intensity of movement into one easily interpretable value, personalized to each individual's physiology. This VLAIO project investigates whether this workflow, using wrist-worn photoplethysmography (PPG) monitors such as smartwatches, is also feasible and applicable in other relevant populations, including oncology, primary care, and exercise coaching. The core intervention consists of a short home-based calibration phase with a PPG compatibility check and an exercise session to determine the maximum heart rate (HRmax). This value is essential for AAI calculation, as it allows physical effort to be assessed relative to each participant's individual capacity, ensuring that only meaningful activity contributes to the fitness score. Following this calibration phase, participants complete six weeks of AAI monitoring and feedback through a dedicated app developed by our team. The primary outcome is feasibility, assessed through predefined targets such as completion of the calibration phase, reliability of PPG measurements, device wear time, validity of AAI scores, app usage, and achievement of the weekly goal of 100 AAI points. Secondary outcomes include user experience, quality of life, and digital readiness. This project represents a crucial intermediate step within a broader valorization trajectory. If successful, the study will demonstrate that AAI monitoring is feasible beyond cardiac rehabilitation, paving the way for large-scale effectiveness studies to establish its clinical impact. Based on these findings, the AAI workflow can be integrated into UZA@Home, the virtual hospital platform of the University Hospital Antwerp (UZA) for telemonitoring and hybrid care. This would create a scalable and sustainable care pathway aligned with existing clinical processes, enabling expansion to other hospitals, primary care networks, and insurers. Such integration opens perspectives for licensing, service models, and potential linkage with commercial wearables. The AAI thus provides a clinically embedded and economically viable solution for personalized, long-term monitoring of physical activity across diverse healthcare domains.

Researcher(s)

• Promoter: Heidbuchel Hein
• Co-promoter: Desteghe Lien

Research team(s)

• Cardiovascular diseases (CARDIOVASC)

Project type(s)

• Research Project

Abstract

Atrial fibrillation (AF) is an increasingly prevalent arrhythmia associated with an increased morbidity and mortality. One should work towards care in which all different risk factors and treatment aspects of AF are tackled in an integrated way. Recently, risk factor management was added as the fourth pillar in AF care, next to oral anticoagulation and rate and rhythm control. Nevertheless, daily care has suboptimal attention to address these modifiable cardiovascular risk factors. There is growing insight that mHealth and new mobile technologies for patient diagnosis, support and follow-up can contribute to the outcome of AF care. This postdoctoral fellowship aims to bring mobile technology and risk factor management together by exploring the use of mHealth into the detection, treatment and follow-up of cardiovascular risk factors (i.e. overweight, obstructive sleep apnea, therapy adherence) to improve the overall care of AF patients. Three studies are planned in the scope of this project: 1) Investigate the impact of the AF-EduApp which is a mobile application for targeted education and adherence reminders on therapy adherence to oral anticoagulation. 2) Evaluate if a structured testing and treatment program for obstructive sleep apnea based on the use of mobile technology has an impact on the proportion of AF and the sleep apnea burden. 3) Explore the effect of a mobile application with a personalised weight loss management program in overweight and obese AF patients.

Researcher(s)

• Promoter: Heidbuchel Hein
• Fellow: Desteghe Lien

Research team(s)

• Cardiovascular diseases (CARDIOVASC)

Project type(s)

• Research Project

Abstract

We want to evaluate the effect of a new and innovative mobile application (self developed) based on intensive targeted education of AF patients. Different unique aspects will be implemented in this application: 1) The JAKQ will be used to provide personalized education for each patient based on general AF knowledge gaps and knowledge gaps about the specific OAC medication of the patients. Patients will receive specific feedback on all aspects of the JAKQ based on written text, images, movies,…; 2) Adherence-motivating aspects will be implemented; 3) Elements to improve patients' self-care will also be incorporated. The primary endpoint of this study will be the percentage of regimen adherence (i.e. proportion of days with the correct number of doses taken) of both AF patients on once daily and twice daily NOAC after a follow-up of 12 months. A second aim of this study is to evaluate the effect of the new mobile application focusing on targeted education on the knowledge level of AF patients and their health status. Additionally, patients' satisfaction about the new mobile application will be evaluated together with the app-use data.

Researcher(s)

• Promoter: Heidbuchel Hein
• Fellow: Desteghe Lien

Research team(s)

• Cardiovascular diseases (CARDIOVASC)

Project type(s)

• Research Project