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Qvist I, Hendriks JM, Møller DS, et al. Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population. Open Heart. 2016;3(1):e000335doi: 10.1136/openhrt-2015-000335.
Qvist, I., Hendriks, J. M., Møller, D. S., Albertsen, A. E., Mogensen, H. M., Oddershede, G. D., Odgaard, A., Mortensen, L. S., Johnsen, S. P., & Frost, L. (2016). Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population. Open heart, 3(1), e000335. https://doi.org/10.1136/openhrt-2015-000335
Qvist, Ina, et al. "Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population." Open heart vol. 3,1 (2016): e000335. doi: https://doi.org/10.1136/openhrt-2015-000335
Qvist I, Hendriks JM, Møller DS, Albertsen AE, Mogensen HM, Oddershede GD, Odgaard A, Mortensen LS, Johnsen SP, Frost L. Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population. Open Heart. 2016 Jan 13;3(1):e000335. doi: 10.1136/openhrt-2015-000335. eCollection 2016. PMID: 26835143; PMCID: PMC4716448.
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Open Heart. 2016 Jan 13;3(1):e000335. doi: 10.1136/openhrt-2015-000335. eCollection 2016.

Effectiveness of structured, hospital-based, nurse-led atrial fibrillation clinics: a comparison between a real-world population and a clinical trial population.

Open heart

Ina Qvist, Jeroen M L Hendriks, Dorthe S Møller, Andi E Albertsen, Helle M Mogensen, Gitte D Oddershede, Annette Odgaard, Leif Spange Mortensen, Søren Paaske Johnsen, Lars Frost

Affiliations

  1. Department of Medicine, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark; Cardiovascular Research Centre, Regional Hospital of Central Jutland, Jutland, Denmark.
  2. Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, South Australian Health and Medical Research Institute, Adelaide, Australia; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
  3. Cardiovascular Research Centre, Regional Hospital of Central Jutland, Jutland, Denmark; Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark.
  4. Spange Statistics , Lystrup , Denmark.
  5. Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.

PMID: 26835143 PMCID: PMC4716448 DOI: 10.1136/openhrt-2015-000335

Abstract

OBJECTIVE: A previous randomised trial showed that structured, nurse-led atrial fibrillation (AF) care is superior to conventional AF care, although further research is needed to determine the outcomes of such care in a real-world setting. We compared the outcomes of patients in real-world, nurse-led, structured hospital AF clinics with the outcomes of a randomised trial of the efficacy of a nurse-led AF clinic, with respect to a composite outcome of cardiovascular-related hospitalisation and death.

METHODS: All patients were referred to the AF nurse specialist by cardiologists. The AF nurse specialist provided patient education, risk-factor control and stimulated empowerment and compliance. During follow-up, treatment was adjusted according to clinical guidelines. Patient education was repeated, and compliance with medical treatment was controlled. The study size was powered as a non-inferiority study. Outcome measures were adjudicated by the same principles in both cohorts.

RESULTS: A total of 596 patients from the real world and 356 patients from a clinical trial were included in this study. No significant difference between groups with respect to age, type of AF or CHA2DS2VASc score was found. The composite primary end point occurred with an incidence rate of 8.0 (95% CI 6.1 to 10.4) per 100 person-years in the real-world population and 8.3 (95% CI 6.3 to 10.9) per 100 person-years in the clinical trial, with a crude HR of 0.83 (95% CI 0.56 to 1.23).

CONCLUSIONS: Structured, nurse-led, hospital-based AF care appears to be effective, and patient outcomes in an actual, hospital-based, structured AF care are as least as good as those in trial settings.

Keywords: QUALITY OF CARE AND OUTCOMES

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