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Structured care of patients with atrial fibrillation improves guideline adherence
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden.
2016 (English)In: Journal of Atrial Fibrillation, E-ISSN 1941-6911, Vol. 9, no 4Article in journal (Refereed) Published
Abstract [en]

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 (HRQo L) 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 HRQo L, and reduce symptoms, anxiety and depression. In 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 Guideline 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. Structured care of patients with AF significantly improved guideline adherence and patients reported fewer symptoms and a reduced negative impact on disease-specific HRQo L compared to standard care at one year follow-up.

Place, publisher, year, edition, pages
CardioFront LLC , 2016. Vol. 9, no 4
Keyword [en]
Anticoagulants; Anxiety; Atrial fibrillation; Guideline adherence; Health-related quality of life; Symptoms
National Category
Cardiac and Cardiovascular Systems Nursing
Identifiers
URN: urn:nbn:se:hj:diva-35437Scopus ID: 2-s2.0-85017534603OAI: oai:DiVA.org:hj-35437DiVA: diva2:1092262
Note

Export Date: 2 May 2017; Article

Available from: 2017-05-02 Created: 2017-05-02 Last updated: 2017-05-02Bibliographically approved

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