Dataset Information

Current management of atrial fibrillation: an observational study in NHS primary care.

ABSTRACT:

Objective

To describe National Health Service (NHS) resource use and pharmacological management of atrial fibrillation (AF) in routine UK primary care.

Design

Multicentre retrospective study.

Setting

Seven primary care practices in England, one in Wales.

Patients

Patients with AF were identified and approached for consent. Data were collected on the first 12 weeks post-diagnosis ('initiation') and, for established patients, up to the most recent 3 years of management ('maintenance').

Results

Data collected on 825 patients with AF, 56% men. Mean age (at diagnosis) 70.5 years. Mean 2.4 (SD 2.2) visits to primary care per patient during the initiation phase; 1.5 (SD 1.8) per patient-year during the maintenance phase. Mean 0.4 (SD 0.6) inpatient admissions for AF per patient during the initiation phase and 0.1 (SD 0.3) per patient-year during the maintenance phase. The mean length of hospital stay per admitted patient was 5.6 days during initiation and 6.4 days per patient-year during maintenance. During the initiation phase, 46.1% (143/310) patients received a ?-blocker and 97 (31.3%) received no rate/rhythm control. Only 234 (75.5%) patients received thromboprophylaxis in the 12 weeks postdiagnosis and 674 (87.7%) in the maintenance phase. 440 (57.2%) patients were deemed to be at high risk of stroke at the end of the maintenance phase; 55% (242/440) of these were receiving appropriate anticoagulation therapy.

Conclusions

The results suggest that there are opportunities for optimisation of treatment and there is significant NHS resource associated with AF management, the details of which are invaluable for future healthcare planning and policy development in this area.

SUBMITTER: Kassianos G

PROVIDER: S-EPMC3840336 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Publications

Current management of atrial fibrillation: an observational study in NHS primary care.

Kassianos George G Arden Chris C Hogan Simon S Dew Robert R Fuat Ahmet A

BMJ open 20131122 11

<h4>Objective</h4>To describe National Health Service (NHS) resource use and pharmacological management of atrial fibrillation (AF) in routine UK primary care.<h4>Design</h4>Multicentre retrospective study.<h4>Setting</h4>Seven primary care practices in England, one in Wales.<h4>Patients</h4>Patients with AF were identified and approached for consent. Data were collected on the first 12 weeks post-diagnosis ('initiation') and, for established patients, up to the most recent 3 years of management ...[more]

PMID: 24271019

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Project description:IntroductionScreening for atrial fibrillation (AF) in people ≥65 years is now recommended by guidelines and expert consensus. While AF is often asymptomatic, it is the most common heart arrhythmia and is associated with increased risk of stroke. Early identification and treatment with oral anticoagulants can substantially reduce stroke risk. The general practice setting is ideal for opportunistic screening and provides a natural pathway for treatment for those identified.This study aims to investigate the feasibility of implementing screening for AF in rural general practice using novel electronic tools. It will assess whether screening will fit within an existing workflow to quickly and accurately identify AF, and will potentially inform a generalisable, scalable approach.Methods and analysisScreening with a smartphone ECG will be conducted by general practitioners and practice nurses in rural general practices in New South Wales, Australia for 3-4 months during 2018-2019. Up to 10 practices will be recruited, and we aim to screen 2000 patients aged ≥65 years. Practices will be given an electronic screening prompt and electronic decision support to guide evidence-based treatment for those with AF. De-identified data will be collected using a clinical audit tool and qualitative interviews will be conducted with selected practice staff. A process evaluation and cost-effectiveness analysis will also be undertaken. Outcomes include implementation success (proportion of eligible patients screened, fidelity to protocol), proportion of people screened identified with new AF and rates of treatment with anticoagulants and antiplatelets at baseline and completion. Results will be compared against an earlier metropolitan study and a 'control' dataset of practices.Ethics and disseminationEthics approval was received from the University of Sydney Human Research Ethics Committee on 27 February 2018 (Project no.: 2017/1017). Results will be disseminated through various forums, including peer-reviewed publication and conference presentations.Trial registration numberACTRN12618000004268; Pre-results.

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Dataset Information

Current management of atrial fibrillation: an observational study in NHS primary care.

Objective

Design

Setting

Patients

Results

Conclusions

Publications

Current management of atrial fibrillation: an observational study in NHS primary care.

Similar Datasets

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