Structured care of patients with atrial fibrillation improves guideline adherence.
نویسندگان
چکیده
Aims 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. Methods 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. Results 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. Conclusion Structured 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.
منابع مشابه
Investigation of the relationship between pharmacological knowledge of anticoagulants with medication adherence in the elderly patients with atrial fibrillation
Introduction and Aim: In the elderly, the rate of adherence to the medication regimen and the rate of remembering how to correctly prescribe medication is low due to old age and memory loss, which leads to poor therapeutic results. The aim of this study was to determine the relationship between anticoagulants knowledge and adherence to treatment in elderly cardiac patients with atrial fibrillat...
متن کاملIncidence of Atrial Fibrillation after Coronary Artery Bypass Graft Surgery and Its Risk Factors in Shiraz, Iran during 2017-18
Background and Objectives: Atrial fibrillation is one of the most common disorientations after coronary artery bypass graft surgery and can affect the chance of survival in the first year after surgery. The present study aimed to determine the incidence of atrial fibrillation after coronary artery bypass graft surgery and its risk factors. Methods: This cross-sectional study was performed on...
متن کاملNurse-led care vs. usual care for patients with atrial fibrillation: results of a randomized trial of integrated chronic care vs. routine clinical care in ambulatory patients with atrial fibrillation.
AIMS The management of patients with atrial fibrillation (AF) is often inadequate due to deficient adherence to the guidelines. A nurse-led AF clinic providing integrated chronic care to improve guideline adherence and activate patients in their role, may effectively reduce morbidity and mortality but such care has not been tested in a large randomized trial. Therefore, we performed a randomize...
متن کاملImproving stroke prevention in patients with atrial fibrillation
BACKGROUND Patients with atrial fibrillation (AF) are at increased risk for stroke. Antithrombotic treatment reduces this risk. Antithrombotic treatment consists of either administration of oral anticoagulants (OAC) or the provision of an antiplatelet drug. International guidelines provide advice on the preferred treatment, thereby balancing the risks and benefits of OAC. However, adherence to ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of atrial fibrillation
دوره 9 4 شماره
صفحات -
تاریخ انتشار 2016