Integrated Care for Atrial Fibrillation in Frail and Multimorbid Adults

“Our aim is to implement and test the effectiveness of an integrated patient-centred holistic care pathway for the management of older patients with AF and multimorbidity, which will facilitate cooperation among different health disciplines and promote a shared decision-making process. This type of personalised approach could potentially lead to a reduction in physical and mental impairment allowing older patients to cope better with multimorbidity.”

“We understand and treat patients better if we look at them from a holistic perspective and see them as human beings with coherent systems of diseases. Otherwise, we simply miss the big picture. But it's a difficult challenge to get the entire healthcare system to organise treatments that match this perspective. It means that we must move away from a 'one size fits all' approach and instead focus on the patient's individual situation and actively involve the patient in decisions about the organisation of the care. That is the great challenge we will address with this project.”