A Randomised Controlled Trial on the Effect of Nurse-Led Educational Intervention at the Time of Catheter Ablation for Atrial Fibrillation on Quality of Life, Symptom Severity and Rehospitalisation

Bowyer, J.; Tully, Phillip J.; Ganesan, Anand N.; Chahadi, F.; McGavigan, Andrew D.

doi:10.1016/j.hlc.2016.04.024

Cited by 28 publications

(37 citation statements)

References 40 publications

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“…A study with 41 patients found a positive effect between groups on two of the eight SF‐36 subscales, physical function, (intervention mean 88.58 vs 70.78 in the control group, P = .002) and vitality, (intervention group 70.86 vs 54.31 in the control group, P = .005). No differences were seen on the other subscales and the overall score not reported 28 …”

Section: Resultsmentioning

confidence: 80%

“…The mean age in the intervention group ranged from 58 to 74.8 years and the control group from 59 to 77.3 years. In eight of the trials, the majority of the participants were males (52.0%‐71.5%) 19‐24,27,28 . Only in the study by Fuenzalida et al 18 did females represent the majority (57.5%).…”

Section: Resultsmentioning

confidence: 88%

“…A total of 2368 patients were included in the trials. All nine trials included patients with AF 18‐24,27,28 . The mean age in the intervention group ranged from 58 to 74.8 years and the control group from 59 to 77.3 years.…”

Section: Resultsmentioning

confidence: 99%

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Educational interventions to improve outcomes in patients with atrial fibrillation—a systematic review

Palm

Qvist

Rasmussen

et al. 2020

Int. J. Clin. Pract.

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Background: Atrial fibrillation (AF) is an emerging epidemic associated with poor mental health and quality of life, as well as morbidity and mortality. Whilst other cardiovascular conditions have demonstrated positive outcomes from educational programmes, this approach is not well integrated in clinical practice in patients with AF. Though evidence in this area is mounting, a thorough overview seems to be lacking. Aim: To assess benefits and harms of educational interventions compared with no intervention in adults with AF. Method: A systematic review and meta-analysis were performed including the outcomes: Serious adverse events (mortality and readmission), mental health (anxiety and depression), physical capacity, quality of life and self-reported incidence of symptoms of AF. PubMed, Embase, CINAHL, Cochrane Library and PsycINFO were searched between June and august 2018. Data extraction and quality assessment were performed independently by two reviewers. The Cochrane Risk of Bias tool was applied for the randomised controlled trials and the Amstar Checklist for the systematic reviews. Results: Eight randomised controlled trials and one non-randomised interventional study were included, with a total of 2388 patients. Comparing with controls patient education was associated with a reduction in: Serious adverse events (Risk Ratio 0.78, CI 95% 0.63-0.97), anxiety with a mean difference of −0.62 (CI 95% −1.21, −0.04) and depression with a mean difference of −0.74 (CI 95% −1.34, −0.14). Health-related quality of life and physical capacity was found to increase after patient education, yet, only one study found statistically significant differences between groups. No differences were observed with regards to self-reported incidence of symptoms of AF. Conclusions: Educational interventions significantly decrease the number of serious adverse events in patients with AF and seem to have a positive impact on mental health and self-reported quality of life. However, the evidence is limited, and more studies are warranted.

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Section: Resultsmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 88%

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Educational interventions to improve outcomes in patients with atrial fibrillation—a systematic review

Palm

Qvist

Rasmussen

et al. 2020

Int. J. Clin. Pract.

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“…Previous investigations in different settings have already shown that trained nurses can have a beneficial impact on drug use, e.g. in the outpatient follow-up of heart failure patients or the management of atrial fibrillation patients, both settings with a high degree of polypharmacy [ 33 , 34 ]. Third, CDSS might play an important role in expanding medication review services in the hospital setting and decreasing therapeutic inertia (e.g.…”

Section: Discussionmentioning

confidence: 99%

Medication review versus usual care to improve drug therapies in older inpatients not admitted to geriatric wards: a quasi-experimental study (RASP-IGCT)

Linden

Hias

Dreessen³

et al. 2018

BMC Geriatr

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BackgroundInterdisciplinary geriatric consultation teams (IGCT) are regularly requested to provide comprehensive geriatric assessments in older inpatients. Our primary aim was to evaluate whether medication reviews increased the number of IGCT-provided drug-related recommendations. Secondary aims were to reduce the number of potentially inappropriate medications (PIMs), and to identify the acceptance rate of and determinants for the number of recommendations.MethodsA before-after study was performed in older inpatients not admitted to acute geriatric wards. The before cohort received usual care (UC); the after cohort was subjected to the intervention (I), consisting of a systematic medication review, based on but not limited to the RASP (Rationalization of Home Medication by an Adjusted STOPP in Older Patients) list. The primary outcome measure was the number of IGCT-provided drug-related recommendations. Age, sex, Charlson Comorbidity Index, creatinine clearance and serum creatinine were ascertained upon enrolment. Following variables were determined on admission and at discharge: number of drugs and number as well as type of RASP-identified PIMs. Acceptance by ward-based physicians was also determined. Poisson regression was performed to identify determinants for the primary outcome measure.ResultsFifty-nine participants were enrolled (nUC = 29; nI = 30). The intervention increased the number of drug-related recommendations from a median of 0 (IQR: 0–1) to 8 (IQR: 6.75–10) (p < 0.001). The median number of accepted recommendations differed significantly as well (UC vs. I: 0.0 (0.0–0.5) vs. 3.0 (0.0–5.3); p < 0.001). In the intervention cohort, patients were discharged with fewer drugs compared to admission (UC vs. I: 108.5%, IQR: 100.0–135.8% vs. 92%, IQR: 80.5–103.5%; p = 0.002). More RASP PIMs were discontinued in the intervention cohort, with a mean difference of 1.49 RASP PIMs (95% confidence interval (CI): 0.70, 2.23; p < 0.001). Regression analysis identified two determinants: allocation to the intervention cohort with an incidence rate ratio (IRR) of 14.1 (95% CI: 8.30, 23.8) and the number of preadmission drugs with an IRR of 1.06 (95% CI: 1.03, 1.09).ConclusionsA structured medication review as part of usual IGCT care may contribute to an increased detection of drug-related problems and help to further reduce polypharmacy in older inpatients, not admitted to acute geriatric care wards.Trial registrationNCT02165618, retrospectively registered June 17, 2014.

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“…The 23 included studies [22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44] were evaluated using the MMAT. The two screening questions applied to all reviewed studies regardless of study design.…”

Section: Methodsmentioning

confidence: 99%

Health-Related Quality of Life and Associated Factors in Patients with Atrial Fibrillation: An Integrative Literature Review

Son

Baek²,

Lee

et al. 2019

IJERPH

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Atrial fibrillation (AF) is a common cardiac arrhythmia associated with poor health-related quality of life (HRQoL). However, the factors influencing HRQoL in patients with AF are not well understood. The purpose of integrative review was to investigate the factors affecting HRQoL in patients with AF based on the six domains of Ferrans and colleagues’ HRQoL model. A total of 23 relevant articles published between January 2000 and March 2018 were identified using four databases and analyzed in this study. Our review showed that the HRQoL in patients with AF was consistently lower than both healthy individuals and patients with other cardiovascular diseases. The most common factor associated with HRQoL in patients with AF was anxiety-specific to AF in the symptoms domain, followed by frequency and severity of symptoms and the New York Heart Association functional class. This study highlights that monitoring and assessing patients’ symptoms is vital for improving HRQoL in patients with AF. Disease-specific and cross-culturally validated tools can allow healthcare professionals to provide tailored interventions for patients with AF.

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A Randomised Controlled Trial on the Effect of Nurse-Led Educational Intervention at the Time of Catheter Ablation for Atrial Fibrillation on Quality of Life, Symptom Severity and Rehospitalisation

Cited by 28 publications

References 40 publications

Educational interventions to improve outcomes in patients with atrial fibrillation—a systematic review

Educational interventions to improve outcomes in patients with atrial fibrillation—a systematic review

Medication review versus usual care to improve drug therapies in older inpatients not admitted to geriatric wards: a quasi-experimental study (RASP-IGCT)

Health-Related Quality of Life and Associated Factors in Patients with Atrial Fibrillation: An Integrative Literature Review

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