Key result
General practice management of permanent AF leaves guideline gaps, achieving a mean ~11-of-14 quality score.
Why the study?
AF poses a significant healthcare burden, prompting the need to develop and test a guideline-based quality of care score for patients with permanent AF in general practice.
Cross-Sectional (n=153)
Yes
The implementation of the MAGIC score is a feasible approach for measuring adherence to atrial fibrillation management guidelines in primary care, revealing specific gaps in bleeding risk assessment and correct oral anticoagulant dosing.
BACKGROUND: Worldwide, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults and poses a significant burden to patients, physicians, and healthcare systems. We developed a quality of care score based on the Atrial Fibrillation Better Care pathway recommended by the European Society of Cardiology and the European Heart Rhythm Association guidelines. This is a 14-point score that we have termed the MAGIC score(Management of Atrial Fibrillation in Integrated Care and General Practice). OBJECTIVE: The objective of this pilot study was to develop and test a quality of care score for patients with permanent AF in general practice. METHODS: An observational cross-sectional pilot study was undertaken. Proportionate sampling was used across 11 practices from the Ireland East practice-based research network. The GPs completed a report form on each patient by undertaking a retrospective chart review. Eleven practices participated with a total of 1855 patients with AF. We received data on 153 patients. RESULTS: The main findings were that no patient met all 14 guideline based recommendations. The mean MAGIC score was 11.3. Points were most commonly deducted because the creatinine clearance and HAS-BLED score were not recorded, and the patient was not on the correct dose of oral anti-coagulation. CONCLUSION: This study demonstrates the feasibility of using a quality of care score to measure the quality of AF management in general practice. This scoring system, which is based on internationally recognized quality of care markers, highlights key areas that can be targeted with quality improvement intervention.
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McErlean et al. (2024) conducted a cross-sectional in Permanent Atrial Fibrillation (n=153). Quality of care management for atrial fibrillation was evaluated on Mean MAGIC quality of care score (out of 14 guideline-based recommendations). In patients with permanent atrial fibrillation managed in general practice, no patient met all 14 guideline recommendations, yielding a mean MAGIC quality of care score of 11.3.
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