Patient Interviews
Themes	Codes	Verbatims
Added value	Diagnostic utility	“No matter how much I explained things, as I never had a trace, it was difficult to make a real diagnosis.” “When I showed them to people, they said, “Oh, yes, that’s exactly what you were describing.”” “It argued what I was describing.” “I gave myself this watch, and as soon as I set it, it says “but you’re in atrial fibrillation.” “She’s already discovered it, and now I can keep track of it all.” “I was able to confirm my symptoms and get a more accurate diagnosis”. “And so afterwards I was able to have an operation”. “Because when I went to the doctor for an electrocardiogram, he couldn’t see anything, but you see it’s normal given that I wasn’t feeling my symptoms at the time, otherwise it’s no fun.” “A diagnosis I made a lot a lot of holter of 24, 48 and a week. But there was really no frequency of tachycardia attacks it was really just coming like that.” “The doctor had told me that it helps a lot in the diagnosis and that otherwise I think he would have had a bigger delay in my diagnosis.” “You’re diagnosed faster.” “It’s fast, you don’t have to wait for an appointment”. “It allowed us to be operated on and have an ablation”. “It allowed me to know what I had, because I was told it was stress but I knew it wasn’t.” “It allowed me to undergo surgery and heal, so it brought me health” “Well, I don’t know at the moment, since I’ve got my watch I haven’t had a tachycardia attack yet, so it’s complicated to tell you”. “For the moment I’m waiting to see, it’s too early I think to know that.”
	Follow-up	“Now I use it to check that everything is fine and that I’m still in sinus.” “The watch alerts me when I have bradycardia after taking bisoprolol, for example.” “From time to time a little check to see if the rhythm and heart rate are fine.” “To make sure everything goes smoothly.”
Financing	Value for money	“The watch is quite expensive, at least 150–200 euros”. “I bought it for 450 euros.” “It’s an Apple® Watch and Apple® is expensive.” “But then it’s a cost.” “It’s a great investment in terms of care.” “In terms of the service it provides and the well-being it gives me.” “I think the cost is still right.” “But it’s a necessary investment that’s paying off.” “I think it’s worth it.” “I think it’s a good investment.” “An Apple® Watch is pretty expensive, like everything else from Apple®. But I like this brand, I think it’s quality and complete”.
	Refund	“I said to myself, ‘It’s not right that this isn’t reimbursed by social security, because we’re saving them money, because every time they go to the doctor for an electrolysis, it costs them money.”
Therapeutic education	Choice of acquisition	“I asked around and bought a Withings® watch”. “Yes, I looked it up on the internet. No one recommended it to me.” “Afterwards, I did a lot of research on the Internet myself, so I already knew a bit about it.” “My husband bought it in a store, I think it was a birthday present.” “A relative advised me to do this.” “So I came up with the idea of buying my watch after having difficulty getting a precise diagnosis from the doctors I saw. And so once in consultation my doctor told me about it and suggested the idea.” “The doctor told me it was great to buy this watch.” “At the time, our rhythmologist advised us to do so.” “It was our rhythmologist who advised us to invest in these watches.” “It was my cardiologiste who advised me to take the watch, and he gave me the brand name too.” “I was advised to buy a watch in consultation to see what I really had.”
	Information	“In the store, I met a gentleman who knew it very well, since his mother owned one, and it was he who guided me.” “So the salesman explained to me in detail how the watch works, because there are so many functions on it.” “Yes, a little. I asked the salesman and he explained everything to me.” “I looked on the internet and then I saw that it was the one that could best match what I had.” “I didn’t feel well and it was a bit like what had happened 16 years ago. So I said to myself, without thinking about it, I’m going to buy myself a watch to follow my heart.” “So when I got home I did some research online and opted for the Fitbit because it seemed to fit my needs.” “I found out about the feature directly on the Internet.” “No, there was the notice in the package.” “It’s the doctor, but it’s quite easy to use. The most complicated part was installing the software, after that it’s a piece of cake.” “Our doctor explained to us how to use it.”
Patient use	Frequency	“Often.” “I do an ECG every week.” “I use it every day, or at least I wear it every day.” “I carried it with me all the time and when I had problems I knew I could use it and do an ECG.” “Before the operation it was once a day and a little less, rarely every day.” “I used to use it very often, every day. But now I look at it from time to time, I think twice a week.” “My watch is always with me and I use it when I don’t feel well. Not every day, but several times a week”. “It’s once or twice a day, it’s not very frequent.” “Now a little less than at the beginning but I continue to wear it every day, I do less tracing maybe 1 per week because I am healed.” “Every day. For a lot of things, whether it’s the sleep app, sms, health and for recordings.”
	Autonomy	“I’m totally autonomous.” “No one but me.” “No, no, all alone.” “I text the ECG to my sister and if it’s abnormal my sister tells me to go to the doctor.” “My wife sometimes, as we have the same problem and both watches, we do together.” “And it was my husband who installed everything on our phones and linked it to the watch.” “Yes, my husband helped me at the beginning to set everything up.” “Yes, my husband helped me. He’s the one who told me about this job and how it worked.” “My friend had given me a briefing.”
	Difficulties	“If it’s a bit anarchic, sometimes the recording is interfered with. No matter how many times I redo it, redo it, redo it, it doesn’t happen.” “It’s just at the beginning of the application installation.” “If it hadn’t been for my husband in the beginning, I think I would have needed someone’s help, at least in the early stages.” “I didn’t need an explanation from the pharmacist because my friend was there, but otherwise I could have asked for help, yes.” “No, it’s fine, my son explained everything to me and I’m very comfortable technology, I’m curious.” “Not really.” “Because it’s easy enough to make an ECG, but it’s hard enough to find it in the Health app, and to interpret it too.” “Not at all, it’s very easy.” “No, never.”
Psychological impact	Positive	“It was rather reassuring.” “The watch really helped me tell myself that it wasn’t just psychological and diagnostic.” “When I look at her it reassures me” “It gives me peace of mind that the operation is still reliable.” “I use the ECG sometimes when I have fears or psychoses, it happens to me… And then it reassures me to see that the ECG is totally normal so I go on with my day.” “But then, on the one hand, it’s reassuring to have it, because if I have a tachycardia attack in the street, I can do an ECG and since I’m already being monitored, we can find out what happened.” “None, we do it when we have a little worry if we feel it throbbing a little bit.” “And for me, the watch is a comfort, because I know that if I have a problem, I can record it and the doctors will be able to treat me.” “It’s true that I have a slight tendency to do ECGs at the slightest symptom when I’m not having an attack.”
	Negative	“I tend to want to go nowhere without it.” “I’m a bit of a slave to the watch, but I’m interested.” “But frankly, I used to be a bit of a hypochondriac.” “Ah yes, what isn’t always very positive can have a real perverse effect too.”
Physician support	Instructions	“Really it was very intense or very violent or clearly the watch is telling me something abnormal because sometimes it says so, in which case I email it directly to the rhythmologist” “After it was recorded in the Apple® health application, I would either send the trace to be exported as a PDF or I would send the trace by e-mail to the doctor or to my sister, who is a doctor.” “If there’s nothing, I don’t move, because the device tells you if you have an arrhythmia, etc. If the device is there, I send it to the rhythmologist with a note by e-mail and then make an appointment.” “In general, I do nothing because it’s business as usual, but if it seems abnormal, I send it to the doctor, who then tells me what to do.” “In fact, they’re recorded on my cell phone in an application whose name I’ve eaten… But it’s the application that’s linked to the watch. And I send it to the doctor when I have a tachycardia attack that’s triggered. For the moment, it hasn’t happened, but twice I’ve sent the ECGs I did during an acceleration to my doctor, but they didn’t see anything on the ECGs, so I’m instructed to continue recording and sending them to get a diagnosis”. “I’m instructed to do tracings at the slightest symptom, and if it’s abnormal I send it to the department secretary. Then the secretary emails me the doctor’s feedback. For the moment I haven’t had a new consultation, I’ve sent a trace but nothing conclusive apparently, so I’m continuing.” “I just look at them, at first I showed them to the doctor and then they operated on me. But now it’s just for my own information, I keep tracking my condition.”
	Follow-up	“In there is a problem I send it to the cardiologist or rhythmologist directly” “If I have a problem, I contact my cardiologist directly, or my general practitioner if the cardiologist doesn’t answer. And if it’s very urgent, I call the emergency services.” “I can also send it to the doctor to tell me what to do”. “We send her an e-mail and she replies very quickly that she knows how to make herself available.”
The role of the dispensing pharmacist	Patient type	“For the operation, someone who wouldn’t actually arrive” “Yes, maybe for people who have a bit more difficulty.” “Yes, it could be a plus, especially for people less at ease with watches.”
	Proximity/trust	“Absolutely, I’ve maintained a relationship of trust with them for 25 years”. “Yes I showed it to the team and told them my story, we talk a lot.” “Yes, very much.” “Yes of course” “By definition, I trust pharmacists.” “Yes, totally.” “I don’t know him very well, but he’s okay medically, yes”. “I talked about it with my friend, yes. He knows a bit about all this and then the younger members of the team too, they’re well connected themselves so it interested them too.” “Yes, to tell the story of what happened when I came back from hospital”. “Yes, a little with the girls from the pharmacy, we chat sometimes when they have time. I told them a bit about my hospitalization, so of course I mentioned the watch”. “It’s difficult to establish a real relationship in the end. I’m welcomed and taken care of, but to say that we’ve been able to establish a relationship of trust, I’d say no.” “No, I didn’t know I could talk to him about it, so I didn’t”. “No, I haven’t been since I got my watch”.
	Training	“It’s in everyone’s interest to wear this watch and for pharmacists and doctors to be trained in the use of these watches to help and reassure us”. “That’s for sure. It’s even better because we don’t know what can happen, so it’s better for doctors, pharmacists and even nurses to be trained”. “I think it needs to do training tailored to that anyway”.
	Follow-up	“Yes, of course, I’m not sure how, but it could be great to do little check-ups with them. My mother received a paper from the health insurance company to do a check-up with her pharmacist, and I think we could do that too.” “For reading electrocardiograms, I don’t think so”.
	User help	“Yes, it’s true that it could be a plus to be able to go to the pharmacy and get help, like when you go to take your blood pressure. Being able to get help and a little support sometimes feels good”. “If he has time he could help to install the software on the laptop and do a first test with the patient”. “I’ve got a health problem and I can find answers on the Internet, because that’s what today’s society is all about: we tend to go straight to the Internet to explain our doubts about something. I’d go and see my pharmacist and ask her what she thinks”. “Maybe when I first bought it I could have asked him directly instead of spending time on the internet. With the internet, you don’t always know whether you’re reading things that are true or false”. “I’d say that, like nurses, we’re capable of reading an ECG and detecting emergencies so we can redirect. It’s true that my sister is a doctor, so I send it to her and she tells me whether or not I’m going to the emergency room, but for someone else, the pharmacist can play this role”. “I don’t know if he can sell them in his pharmacy. But he can help us if we’re having trouble. If it hadn’t been for my husband in the beginning, I think I’d have needed someone’s help, at least in the beginning. After that, it’s a breeze.” “Yes, certainly, to explain how it works. I didn’t need an explanation from the pharmacist because my friend was there, but otherwise I could have asked for help, yes.”
	Limits	“But there’s nothing in it for him, let’s say.” “The pharmacist is not involved because it doesn’t require consumables or anything so…”