Iterative co-production with patients meaningfully reshaped atrial fibrillation self-help guidance, shifting to inclusive language and strongly endorsing blood pressure self-monitoring.
Co-producing lifestyle guidance with AF patients improves the relevance and acceptability of self-management resources, highlighting patient preference for accessible tools like blood pressure self-monitoring.
Objective: Atrial fibrillation (AF) is strongly associated with modifiable lifestyle risk factors, including hypertension, alcohol, obesity, activity and stress. Although lifestyle modification is recommended, patients report that existing information is overwhelming, inconsistent or poorly aligned with lived-experience of AF, limiting engagement with self-help and prevention. Aim: To co-produce, with patients, a prototype AF self-help manual, informed by an umbrella review, that was acceptable and had real-world relevance. Design and method: We took a structured, iterative co-production approach informed by a person-based approach, prioritising acceptability, usability and lived-experience alongside clinical evidence. Between 2024–2025, online patient and public involvement (PPI) workshops (6–8 contributors per session) were conducted with people living with AF, purposively sampled to reflect maximum diversity. Workshops were structured around accessible evidence summaries derived from a related umbrella review of AF lifestyle interventions, focussing on blood pressure (BP) monitoring, physical activity, reducing alcohol and caffeine consumption, smoking cessation, anticoagulation adherence, diet and weight management, and managing stress, anxiety and depression. Contributors reviewed and refined evidence-based content to identify priorities, clarify uncertainties and ensure relevance. Iterative revisions were documented using structured “tables of change”. Results: Co-production led to significant refinements, including: (1) a shift from prescriptive to inclusive, non-judgemental language; (2) normalisation of emotional responses to AF with safety-netting and signposting; (3) clearer explanations of hypertension, BP targets and anticoagulation to support informed decision-making; and (4) strong endorsement of BP self-monitoring as an accessible alternative to clinic-based measurement where travel, time, cost or symptom fluctuation present barriers. Guidance is being refined to integrate practical self-monitoring, action planning, personalised trigger identification, multiple content formats, signposting and clinician-facing decision-support to facilitate shared conversations in primary care. Conclusions: Iterative co-production using a person-based approach meaningfully reshaped AF self-help guidance, aligning umbrella review lifestyle intervention evidence with AF patient priorities. Perceived benefits of BP self-monitoring highlight its potential to support accessible, prevention-focused cardiovascular care in the community. Findings provide a strong foundation for feasibility and implementation studies evaluating home and wearable BP monitoring within primary care to improve AF and hypertension management.
Cross et al. (Fri,) conducted a other in Atrial fibrillation. Co-production of AF self-help manual was evaluated on Refinements to the AF self-help manual. Iterative co-production with patients meaningfully reshaped atrial fibrillation self-help guidance, shifting to inclusive language and strongly endorsing blood pressure self-monitoring.