Nurse-Led, Protocol-Based Atrial Fibrillation Clinic Results in Excellent Compliance with Guidelines

Adherence to guidelines regarding anticoagulation and risk factors for progression of atrial fibrillation in a nurse‐led clinic

“…We feel that a nurse-led clinic model is an efficient and holistic approach in management of AF patients. 6,8,9,20 Our study demonstrated that increasing age is associated with progression of AF. Ageing leads to structural remodelling of atria through progressive fibrosis, creating conduction abnormalities such as increased p-wave duration that is thought to be a trigger for the onset of AF.…”

“…17 However, anticoagulation rates in the community have improved over time due to increasing awareness and introduction of NOACs, as evident in a 2017 US study which observed an increase in the overall rate of anticoagulation from 52.4% to 60.7% over a period of 6 years. 18 Management of AF in a nurse-led clinic is associated with superior outcomes to standard care as this approach allows an individualised focus on patient care, education regarding their medical condition, preventative advice based on guidelines, increased time spent with patients mediated by teamwork between the nurse and cardiologist [6][7][8][9] and effective healthcare resource utilisation. 19 The benefits of a nurse-led clinic are based on a patient-centred integrated approach to the management of AF which includes patient involvement, shared decision-making and improved quality of life.…”

“…19 The benefits of a nurse-led clinic are based on a patient-centred integrated approach to the management of AF which includes patient involvement, shared decision-making and improved quality of life. [6][7][8][9] This patient-centred approach is now recommended by international guidelines for AF management 20 as it is associated with better management of risk factors for AF, 21 enhanced guideline adherence, 22 lower economic and resource burden, 23 reduced cardiovascular-related hospitalisations and reduced all-cause mortality, 20 thereby improving outcomes of patients with this chronic condition. We feel that a nurse-led clinic model is an efficient and holistic approach in management of AF patients.…”

“…Newly diagnosed patients are evaluated by a nurse and then a cardiologist to determine their CHA 2 DS 2 -VASC and HAS-BLED scores, risk factors and relevant further investigations. 9 An algorithm based on ESC guidelines was used to treat patients, which included recommended use of anticoagulants for those with CHA 2 DS 2 -VASC score of ≥2, referral for direct current cardioversion, cardiac rehabilitation and advice for risk factor control including weight management. 9 The primary aim of this retrospective study was to determine the level of adherence to evidence-based guidelines regarding anticoagulation in our study group of patients attending the AF clinic.…”

“…9 An algorithm based on ESC guidelines was used to treat patients, which included recommended use of anticoagulants for those with CHA 2 DS 2 -VASC score of ≥2, referral for direct current cardioversion, cardiac rehabilitation and advice for risk factor control including weight management. 9 The primary aim of this retrospective study was to determine the level of adherence to evidence-based guidelines regarding anticoagulation in our study group of patients attending the AF clinic. The secondary aim of this study was to determine the influence of other risk factors including age, obesity, excessive alcohol intake and hypertension on progression of AF in our study group.…”