Abstract
Aims: As part of the EHRS-PATHS study examining comorbidities in Atrial Fibrillation across Europe, the aim was (i) to evaluate how multimorbidity is currently addressed by clinicians during AF treatment to characterize the treatment structure and (ii) to assess how the interdisciplinary management of multimorbid AF is currently conducted.
Methods: An online survey was distributed amongst EHRA members in Europe that included 21 questions and free-text option for comments on detection, assessment and management of AF-related comorbidities.
Results: A total of 451 responses were received with 339 responses eligible for inclusion. Of these, 221 were male (66%), 300 (91.5%) were physicians and 196 (57.8%) were working in academic university teaching hospitals. Half of the respondents managed between 20 to 50 patients per month with multimorbid AF. Varying rates of specialist services and referral to these services were available at each location (e.g. heart failure and diabetes), with a greater number of specialist services available at academic university teaching hospitals compared to non-teaching hospitals(e.g. anticoagulation 92 (47%) vs 50 (35%), p<0.03). Barriers to referring to specialist services for AF comorbidities included lack of integrated care model (n=174, 51%), organisational or institutional issues (n=145, 43%) and issues with patient adherence (n=126, 37%) highlighting the need for organisational restructuring and developing an integrated collaborative evidenced-based approach to multimorbid AF care.
Conclusion: The survey and analyses of free-text comments demonstrated the need for systematic, integrated management of AF-related comorbidities and these results will inform the next phases of the EHRA-PATHS study.
Methods: An online survey was distributed amongst EHRA members in Europe that included 21 questions and free-text option for comments on detection, assessment and management of AF-related comorbidities.
Results: A total of 451 responses were received with 339 responses eligible for inclusion. Of these, 221 were male (66%), 300 (91.5%) were physicians and 196 (57.8%) were working in academic university teaching hospitals. Half of the respondents managed between 20 to 50 patients per month with multimorbid AF. Varying rates of specialist services and referral to these services were available at each location (e.g. heart failure and diabetes), with a greater number of specialist services available at academic university teaching hospitals compared to non-teaching hospitals(e.g. anticoagulation 92 (47%) vs 50 (35%), p<0.03). Barriers to referring to specialist services for AF comorbidities included lack of integrated care model (n=174, 51%), organisational or institutional issues (n=145, 43%) and issues with patient adherence (n=126, 37%) highlighting the need for organisational restructuring and developing an integrated collaborative evidenced-based approach to multimorbid AF care.
Conclusion: The survey and analyses of free-text comments demonstrated the need for systematic, integrated management of AF-related comorbidities and these results will inform the next phases of the EHRA-PATHS study.
| Original language | English |
|---|---|
| Journal | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology |
| Publication status | Accepted/In press - 19 Jul 2022 |
Keywords
- Atrial fibrillation
- comorbidity
- integrated care
- management