What question did this study set out to answer?

This study aims to evaluate the effectiveness of a nurse-run clinic on managing atrial fibrillation in newly diagnosed patients.

January 13, 2016Journal of the American Heart AssociationOpen Access

An Integrated Management Approach to Atrial Fibrillation

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Why the study?

Does a nurse-run, physician-supervised AF clinic reduce the composite of death, cardiovascular hospitalization, and AF-related emergency department visits in patients with newly diagnosed AF compared to usual care?

Population

433 patients with newly diagnosed atrial fibrillation in 3 emergency departments in Nova Scotia, mean age…

Comparison

Nurse-run, physician-supervised AF clinic. vs Usual-care pathway for AF management.

Design

Cohort

Follow-up

12 months

Authors

LCLindsey CarterUniversity of Alberta MGMartin GardnerDalhousie University KMKirk MageeDalhousie University

Discussion

Member takes

Implication

May support nurse-led AF clinics; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

This study aims to evaluate the effectiveness of a nurse-run clinic on managing atrial fibrillation in newly diagnosed patients.
Before-and-after study of 433 patients in Nova Scotia from 2011 to 2014.
Patients received usual care in the 'before' phase and were enrolled in a nurse-run, physician-supervised clinic in the 'after' phase.
Propensity analysis was used to adjust for baseline characteristic differences.
44% of women and mean age was 64 with a primary outcome occurrence of 26.2% in usual care versus 17.3% in the clinic (odds ratio 0.71; 95% CI [0.59, 1]; P=0.049).
Oral anticoagulation prescription rose to 88.4% in the AF clinic group for CHADS2 ≥2 compared to 58.5% in usual care (P<0.01).

Structured PICO

Population

433 patients with newly diagnosed atrial fibrillation (AF) in 3 emergency departments in Nova Scotia, mean age 64±15 years, 44% women.

Intervention

Nurse-run, physician-supervised AF clinic (integrated management approach).

Comparator

Usual-care pathway for AF management.

Outcome

Composite of death, cardiovascular hospitalization, and AF-related emergency department visits at 12 months.composite

An integrated, nurse-run and physician-supervised AF clinic significantly reduced the composite of death, cardiovascular hospitalization, and AF-related emergency visits compared to usual care.

Cite This Study

Carter et al. (2016) studied this question.

synapsesocial.com/papers/6a0fcadd4fb650da4ffe8447 https://doi.org/10.1161/jaha.115.002950

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management AF ablation outcomes

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An Integrated Management Approach to Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

An Integrated Management Approach to Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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