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Structured care of patients with atrial fibrillation improves guideline adherence
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- Barmano, Neshro, 1980- (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Department of Internal Medicine, County hospital Ryhov, Jönköping, Sweden;Jönköping Academy, Jönköping University,Jönköping, Sweden.
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- Walfridsson, Ulla, 1957- (author)
- Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Walfridsson, Håkan, 1949- (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- (creator_code:org_t)
- 2016-12-31
- 2016
- English.
- In: Journal of Atrial Fibrillation. - Overland Park, KS, United States : CardioFront LLC. - 1941-6911. ; 9:4
- Journal article (peer-reviewed)
Abstract
Subject headings
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- There are many reports of lack of guideline adherence in the treatment of patients with atrial fibrillation (AF), and AF affects health-related quality of life (HRQoL) negatively. The aim of this study was to investigate whether structured care compared to standard care of a general AF population could improve guideline adherence and HRQoL, and reduce symptoms,anxiety and depression.MethodsIn total, 176 patients were recruited to the intervention and 146 patients to the control group.The intervention consisted of a structured follow-up program, while patients serving as controls received standard care. The primary outcome was guideline adherence evaluated through: appropriate use of oral anticoagulants (OAC) and antiarrhythmics, whether echocardiogram and thyroid lab tests were performed, and patient-reported outcome measures (PROMs), assessed with the questionnaires SF-36, EQ-5D, HADS and ASTA at baseline and after one year.ResultsGuideline adherence was significantly better in the intervention group, 91% vs. 63% (p < 0.01), mainly due to appropriate OAC treatment 94% vs. 74% (p < 0.01). Symptoms assessed with ASTA were less frequent and the negative impact of AF was reduced in the intervention group after one year/ at follow-up. Five scales in SF-36, and the visual analogue scale for current health status in EQ-5D (EQ-VAS), improved significantly in both groups.ConclusionStructured care of patients with AF significantly improved guideline adherence and patients reported fewer symptoms and a reduced negative impact on disease-specific HRQoL compared to standard care at one year follow-up.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
Keyword
- Atrial fibrillation
- Guideline Adherence
- Anticoagulants
- Health-related Quality of life
- Symptoms
- Anxiety.
Publication and Content Type
- ref (subject category)
- art (subject category)
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