Key result
Guideline-recommended ABC pathway care is linked to fewer strokes and deaths in rural AF patients.
Why the study?
Data from atrial fibrillation registries in the rural elderly are limited, and contemporary data were needed on the health status and management gaps by village doctors in rural China.
Does intensified education and village doctor training on the ABC pathway improve clinical outcomes in rural elderly patients with atrial fibrillation?
Observational (n=18,712)
Yes
Does intensified education and village doctor training on the ABC pathway improve clinical outcomes in rural elderly patients with atrial fibrillation?
This large prospective observational study will provide contemporary data on AF prevalence and evaluate the impact of an integrated care pathway (ABC) managed by village doctors in rural China.
China has a large population of elderly in rural areas. Village doctors are acting as health-care gatekeepers for the rural elderly in China and are encouraged to provide more long-term care for patients with chronic diseases such as atrial fibrillation (AF). The data of AF registries from the rural elderly are limited. The present registry aims to provide contemporary data on the current AF-related health status of the rural elderly and the gaps in management of AF by village doctors. This study has two phases. The first phase is a cross-sectional study of AF screening in two rural towns of eastern China. All the residents aged ≥65 years are eligible and will be invited to attend a government-led health examination or an in-house AF screening program. The AF detection rate, the awareness of AF and the usage of oral anticoagulants and smartphones by AF patients, and the ability to diagnose and manage AF by village doctors will be assessed. Participants with AF detected in the first phase are eligible for the second phase. A variety of modes of intensified education will be provided to all AF patients and their family members to enrich their AF-related knowledge. Their village doctors will be offered a lecture-based training program focusing on Atrial fibrillation Better Care (ABC) pathway. Follow-up will be conducted for 1 year. The primary endpoint is the composite of all stroke and all-cause mortality. The first phase of AF screening was conducted between April 2019 and June 2019, and 18,712 participants with the mean age of 73.1±5.8 years were enrolled. The second phase that includes 810 patients with AF, started on 1 May 2019. This study will provide a perspective of primary care system and would indirectly reflect the current status of chronic disease care in rural China.
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Li et al. (2022) conducted an observational in Atrial fibrillation (n=18,712). Atrial fibrillation screening and integrated care (ABC pathway) vs. Non-ABC compliant group or participants without AF was evaluated on Composite of all stroke and all-cause mortality. The Jiangsu Province Rural Community AF project enrolled 18,712 rural elderly residents for AF screening, identifying 810 patients with AF for a 1-year prospective observational registry to evaluate clinical outcomes.
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