Structured care of patients with atrial fibrillation improves guideline adherence

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Barmano, Neshro,1980-Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Department of Internal Medicine, County hospital Ryhov, Jönköping, Sweden;Jönköping Academy, Jönköping University,Jönköping, Sweden. (author)

Structured care of patients with atrial fibrillation improves guideline adherence

Article/chapterEnglish2016

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2016-12-31
Overland Park, KS, United States :CardioFront LLC,2016
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:liu-157019
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-157019URI
https://doi.org/10.4022/jafib.1498DOI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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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 and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences hsv//eng
Atrial fibrillation
Guideline Adherence
Anticoagulants
Health-related Quality of life
Symptoms
Anxiety.

Added entries (persons, corporate bodies, meetings, titles ...)

Walfridsson, Ulla,1957-Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ullwa37 (author)
Walfridsson, Håkan,1949-Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)hakwa83 (author)
Karlsson, Jan-Erik,1957-Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Department of Internal Medicine, County hospital Ryhov, Jönköping, Sweden;Jönköping Academy, Jönköping University,Jönköping, Sweden.(Swepub:liu)janka97 (author)
Linköpings universitetAvdelningen för kardiovaskulär medicin (creator_code:org_t)

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In:Journal of Atrial FibrillationOverland Park, KS, United States : CardioFront LLC9:41941-6911

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