Key result
Mobile-health ABC pathway plus CGA care is evaluated for unplanned hospitalizations in multimorbid AF.
Why the study?
An integrated care approach using the Atrial Fibrillation Better Care pathway reduces adverse events, but prior trial evidence was limited to two non-European trials.
Does a mobile-health integrated care approach based on the ABC pathway combined with a multidimensional Comprehensive Geriatric Assessment reduce the 12-month risk of unplanned all-cause hospitalizations in patients with AF ≥65 years with ≥1 concomitant chronic condition(s)?
RCT
Open-label
cluster-randomized
Yes
Does a mobile-health integrated care approach based on the ABC pathway combined with a multidimensional Comprehensive Geriatric Assessment reduce the 12-month risk of unplanned all-cause hospitalizations in patients with AF ≥65 years with ≥1 concomitant chronic condition(s)?
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Contemporary AF care emphasizes an integrated approach focused on stroke prevention, symptom management, and optimization of cardiovascular risk factors and comorbidities. The AFFIRMO trial evaluated whether an app-based intervention could improve adherence to ABC pathway-guided care and enhance clinical outcomes in patients with AF.”
The AFFIRMO trial will evaluate whether a mobile-health integrated care approach combined with comprehensive geriatric assessment reduces unplanned hospitalizations in older, multimorbid patients with atrial fibrillation.
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia in older people, with an increasing prevalence of various geriatric conditions, such as multimorbidity, and frailty. A contemporary integrated approach is effective in reducing the risk of clinical adverse events, particularly when streamlined through the application of the Atrial Fibrillation Better Care (ABC) pathway, as proven in 2 non-European trials. METHODS: The atrial fibrillation integrated approach in frail, multimorbid and polymedicated older people (AFFIRMO) trial, a European multicenter, open-label, cluster-randomized study, will examine whether a mobile-health integrated care approach based on the ABC pathway combined with a multidimensional Comprehensive Geriatric Assessment (CGA) can reduce the 12-month risk of unplanned all-cause hospitalizations in patients with AF ≥65 years with ≥1 concomitant chronic condition(s). Hypertension was reported in 992 (78.7%) patients, and diabetes mellitus in 369 (29.3%) patients. Among the enrolled patients, 507 (40.5%) were prefrail, and 171 (13.7%) were frail. Oral anticoagulants (OACs) were prescribed for 1,225 (97.2%) patients, with 1,149 (91.2%) patients receiving non-VKAs oral anticoagulants (NOACs). Follow-up is ongoing and planned to be completed in January 2026. CONCLUSIONS: The AFFIRMO trial will provide evidence on the efficacy of the ABC pathway in conjunction with the CGA approach in reducing the risk of unplanned all-cause hospitalizations and other clinical adverse events in older, multimorbid patients with AF. REGISTRATION: ClinicalTrials.gov identifier: NCT06775028.
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Proietti et al. (2026) conducted an RCT in Atrial fibrillation with multimorbidity. Mobile-health integrated care based on the ABC pathway combined with a Comprehensive Geriatric Assessment (CGA) was evaluated on 12-month risk of unplanned all-cause hospitalizations. Mobile-health ABC pathway care plus CGA is being evaluated for 12-month unplanned hospitalizations in older multimorbid AF patients (97.2% on OACs, 13.7% frail; follow-up ongoing).
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