Implementation of patient education for patients with atrial fibrillation: nationwide cross-sectional survey and one-year follow-up

Abstract

Background Clinical practice guidelines recommend patient education for patients with atrial fibrillation (AF) as a part of holistic care, however clinical guidelines lack detailed specification the content, structure, and delivery of AF education programmes. Aim To examine the implementation of education for patients with AF in Denmark in relation to coverage, organization and content. Methods A cross-sectional survey was conducted from February to May 2021. The survey contained questions on the organization, delivery and content of education for patients with AF from all 29 AF outpatient hospital sites in Denmark. The survey was conducted by email and telephone. One-year follow-up was done in May 2022 by e-mail. Results Patient education was provided by healthcare professionals in 16 (55%) hospitals. Nurse workforce issues, management, non-prioritisation, and lack of guidance for implementation were reasons for the absence of patient education in 13 (45%) hospitals. The structure of patient education differed in relation to group or individual teaching methods and six different education models were used. Content of the AF disease education was generally similar. At 1-year follow-up, another four hospitals reported offering patient education (69% in total). Conclusion Initially almost half of the hospitals did not provide patient education, but at 1-year follow-up 69% of hospitals delivered patient education. Patient education was heterogeneous in relation to delivery, frequency and duration. Future research should address individualized patient education that may demonstrate superiority in relation to quality of life, less hospital admissions, and increased longevity.

The Danish Atrial Fibrillation Registry: A Multidisciplinary National Pragmatic Initiative for Monitoring and Supporting Quality of Care Based on Data Retrieved from Administrative Registries

“…A recent survey of AF service at Danish hospitals reported that under-use of patient education was explained by a lack of nursing resources, uncertainty in relation to what and how to deliver education, and low management priority. 23 …”

Nonpharmacological Approach to Managing Atrial Fibrillation: A Review

“…Recent evidence underscores the potential benefits of lifestyle modifications in AF management, with a specific focus on autonomic nervous system modulation [52]. These modifications exhibit the capacity to influence arrhythmia development and AF therapy by impacting autonomic tone [53,54]. Feasibility trials have probed the effects of autonomic modulation therapy, aiming to enhance AF management [55].…”

“…This impact is particularly pronounced on heart rate and parasympathetic modulation [58,59]. Intriguingly, music intervention in tandem with lifestyle modifications has shown promise in promoting autonomic balance among individuals with prehypertension and hypertension [54]. The potential of lifestyle changes to improve cardiac autonomic health and mitigate transient increases in cardiac autonomic modulation is also suggested [59].…”

“…Autonomic modulation strategies align with the evolving landscape of AF management [52]. Lifestyle modifications, fortified by evidencebased research, hold potential to mitigate cardiovascular diseases and enhance AF management outcomes [54]. The realm of interventions includes physical activity, dietary adjustments, and music-based strategies, aimed at augmenting cardiac autonomic function and controlling heart rate variability [58,59].…”

“…Effective patient education, often facilitated through tailored health information packages, amplifies the impact of these lifestyle interventions [63]. Exercise and other lifestyle changes collectively stand as essential components of AF management, steering disease progression and optimizing patient outcomes [53,54].…”