An integrated chronic care program for patients with atrial fibrillation
Abstract
Background Adherence to guidelines for the management of atrial fibrillation (AF) is often poor, although this is associated with improved morbidity and mortality in such patients. Increasing numbers of programs are designed to enhance appropriate counselling, treatment and coordinated care delivery including the nurse-led, guidelines-based, software-supported integrated chronic care program (ICCP) for patients with AF reported here.Objectives This paper outlines the study protocol and methodology currently being used to evaluate the effectiveness of a newly developed nurse-led, guideline-based, software-supported ICCP for patients with AF.Design and methods Evaluation of the ICCP is currently being carried out in the outpatient care setting known as the AF-Clinic. A prospective randomised controlled trial is currently underway in the outpatient AF-Clinic of a University Hospital in the Netherlands in cooperation with the collaborating university. The primary outcome measures are cardiovascular hospitalisation and/or death. Secondary outcome measures include guideline adherence, patient knowledge about their condition, quality of life, satisfaction and other outcome measurements such as cost-effectiveness.Participants It was calculated that 698 participants are needed to demonstrate discernible outcomes in relation to the primary endpoint (349 patients in each group) with follow-up after 1 year.Results The study started in January 2007 and the first results are expected in the beginning of 2010.Conclusions It is hypothesised that the ICCP may contribute towards closing the gap between guideline recommendations and current practice in the management of atrial fibrillation. Furthermore, it is hypothesised that the program has the potential to optimise the management of AF patients and improve the efficiency and coordination of patient care. This may lead to better patient outcomes including improved quality of life and patient satisfaction in such patients.
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Technology, such as decision support software, has the potential to enhance the implementation of evidence-based care and improve outcomes, when used to enhance expert advice.
“Technology, such as decision support software, has the potential to enhance the implementation of evidencebased care and improve outcomes, when used to enhance expert advice.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [338]
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Self-citation
- Authors
- Hendriks, J. M. L., de Wit, R., Vrijhoef, H. J. M., Tieleman, R. G., & Crijns, H. J. G. M.
- Affiliations
- Maastricht University Medical Centre (NL)
- Martini Ziekenhuis (NL)
- Corresponding author
- Hendriks, Jeroen M.L.
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 47
- Issue
- 10
- Pages
- 1310-1316
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W1518629592
- Cited by
- 41
- References
- 29
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 6 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Funders
- Care and Public Health Research Institute, Universiteit Maastricht
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- atrial fibrillation, nurse-led care, guideline adherence, cardiovascular hospitalization, cardiovascular mortality, patient knowledge, quality of life, patient satisfaction, care coordination, cost-effectiveness
- MeSH terms
- Atrial Fibrillation, Chronic Disease, Humans, Prospective Studies, Quality of Life
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