Key result
Shared medical appointments for patients with atrial fibrillation resulted in similar perceived self-management at 6 months compared to standard care (mean difference -6.5; p=0.21), while significantly improving patient knowledge about the disease.
Why the study?
Shared medical appointments target lifestyle change effectively in other chronic diseases, but whether they benefit patients with AF treated with ablation therapy was unknown.
Do shared medical appointments improve perceived self-management and satisfaction with provider communication in patients with atrial fibrillation undergoing ablation?
Observational (n=123)
None for patients/providers; outcome assessors (data abstractors) were blinded
None (assigned based on patient's preferred appointment date)
No
Do shared medical appointments improve perceived self-management and satisfaction with provider communication in patients with atrial fibrillation undergoing ablation?
Mean Difference: -6.5 (95% CI -16.6–3.6)
Absolute Event Rate: 65.3% vs 71.8%
p-value: p=0.21
Shared medical appointments for patients undergoing atrial fibrillation ablation improve disease knowledge and goal setting without negatively impacting perceived self-management or satisfaction.
BACKGROUND: People with atrial fibrillation (AF) have lower reported quality of life and increased risk of heart attack, death, and stroke. Lifestyle modifications can improve arrhythmia-free survival/symptom severity. Shared medical appointments (SMAs) have been effective at targeting lifestyle change in other chronic diseases and may be beneficial for patients with AF. OBJECTIVE: To determine if perceived self-management and satisfaction with provider communication differed between patients who participated in SMAs compared to patients in standard care. Secondary objectives were to examine differences between groups for knowledge about AF, symptom severity, and healthcare utilization. METHODS: We conducted a retrospective analysis of data collected where patients were assigned to either standard care (n = 62) or a SMA (n = 59). Surveys were administered at pre-procedure, 3, and 6 months. RESULTS: Perceived self-management was not significantly different at baseline (p = 0.95) or 6 months (p = 0.21). Patients in SMAs reported more knowledge gain at baseline (p = 0.01), and higher goal setting at 6 months (p = 0.0045). Symptom severity for both groups followed similar trends. CONCLUSION: Patients with AF who participated in SMAs had similar perceived self-management, patient satisfaction with provider communication, symptom severity, and healthcare utilization with their counterparts, but had a statistically significant improvement in knowledge about their disease.
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Schmidt et al. (2021) conducted an observational in Atrial Fibrillation (n=123). Shared medical appointments (SMAs) vs. Standard care (up to 60-minute individual visits) was evaluated on Perceived self-management (Patient Activation Measure score) at 6 months (MD -6.5, 95% CI -16.6 to 3.6, p=0.21). Shared medical appointments for patients with atrial fibrillation resulted in similar perceived self-management at 6 months compared to standard care (mean difference -6.5; p=0.21), while significantly improving patient knowledge about the disease.
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