The Effect of Nurse Practitioner-Led Care on Health-Related Quality of Life in Adult Patients with Atrial Fibrillation – A Randomized Controlled Trial

Background: Atrial fibrillation (AF) is associated with significant morbidity, mortality and healthcare resource utilization.Health system limitations can result in delays to specialty cardiovascular (CV) care.Nurse practitioner (NP)-led care may improve access and quality of care.The purpose of this study was to assess effect of NP-led care compared to usual cardiologist care on quality of life in patients with AF.Methods: Patients with AF referred to a specialized cardiac clinic were randomized to NP-led or usual cardiologist care for 6 months.Primary outcome was difference in change in Atrial Fibrillation Effect on Quality of Life (AFEQT) scores at 6 months between groups.Secondary outcomes were difference in change of EuroQOL EQ-5D-3L scores at 6 months between groups, composite outcome of death from CV causes, hospitalizations, emergency department visits, and patient satisfaction measured by the Consultant Satisfaction Questionnaire (CSQ) at six months. Results:We enrolled 150 subjects, with 10% loss to follow up.Study subjects were 62% male, mean age 64 years, overall AFEQT baseline score 66.45+4:86.There were no significant baseline differences between groups.AFEQT scores, EQ-5D-3L and CV outcomes were not different at 6 months, NP-led care showed higher patient satisfaction in the CSQ domain of professional care (76.32 +11.32 vs 65.75+15.45,p=0.0006). Conclusion:We found no difference in quality of life or CV outcomes at 6 months with NP-led care vs usual cardiologist care.NP-led care resulted in higher patient satisfaction.Further research is needed to explore the effect of NP-led AF care in CV settings Clinical Trial Registration NCT02745236