Key result
Nurse-led integrated AF care reduces all-cause mortality ~45% vs usual care in one trial.
Why the study?
Despite recommendations for integrated care, scientific evidence regarding the effects of nurse-led AF clinics in primary health care remains lacking.
Does nurse-led care reduce mortality and hospitalizations in patients with atrial fibrillation in primary health care?
Systematic Review
Does nurse-led care reduce mortality and hospitalizations in patients with atrial fibrillation in primary health care?
Effect estimate: 45% reduction (95% CI 0.37-0.82)
While evidence is currently limited to a single study, nurse-led atrial fibrillation clinics in primary health care may significantly reduce all-cause mortality and hospitalizations compared to usual care.
May support nurse-led AF care in primary settings to cut mortality; leaves open confirmation beyond one trial.
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects. AIM: To review the scientific literature regarding the effects of nurse-led AF clinics in PHC. METHODS: A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles. RESULTS: Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments. CONCLUSIONS: Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.
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Dahlberg et al. (2025) conducted a systematic review in Atrial fibrillation. Nurse-led care vs. Usual care was evaluated on All-cause mortality (45% reduction, 95% CI 0.37-0.82). Nurse-led integrated care for atrial fibrillation in primary health care reduced all-cause mortality by 45% compared to usual care, though evidence is currently limited to a single trial.
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