Shared medical appointments: Translating research into practice for patients treated with ablation therapy for atrial fibrillation

Abstract

Background People with atrial fibrillation (AF) have lower reported quality of life and increased risk of heart attack, death, and stroke. Lifestyle modifications can improve arrhythmia-free survival/symptom severity. Shared medical appointments (SMAs) have been effective at targeting lifestyle change in other chronic diseases and may be beneficial for patients with AF. Objective To determine if perceived self-management and satisfaction with provider communication differed between patients who participated in SMAs compared to patients in standard care. Secondary objectives were to examine differences between groups for knowledge about AF, symptom severity, and healthcare utilization. Methods We conducted a retrospective analysis of data collected where patients were assigned to either standard care (n = 62) or a SMA (n = 59). Surveys were administered at pre-procedure, 3, and 6 months. Results Perceived self-management was not significantly different at baseline (p = 0.95) or 6 months (p = 0.21). Patients in SMAs reported more knowledge gain at baseline (p = 0.01), and higher goal setting at 6 months (p = 0.0045). Symptom severity for both groups followed similar trends. Conclusion Patients with AF who participated in SMAs had similar perceived self-management, patient satisfaction with provider communication, symptom severity, and healthcare utilization with their counterparts, but had a statistically significant improvement in knowledge about their disease.

Assessing the impact of atrial fibrillation self-care interventions: A systematic review

“…Many interventions featured in-person delivery (n = 19), supplemented by telephone follow-ups (n = 9) and technological aids such as mobile apps, web portals, and a virtual relational agent (n = 1). Only four of the included studies used a theory or model to guide their intervention development [ [27] , [28] , [29] , [30] ]. Two studies used theories of behavior change [ 27 , 28 ], one used a chronic care framework, specifically designed for quality improvement [ 29 ], and one was guided by an empowerment model [ 30 ].…”

“…Only four of the included studies used a theory or model to guide their intervention development [ [27] , [28] , [29] , [30] ]. Two studies used theories of behavior change [ 27 , 28 ], one used a chronic care framework, specifically designed for quality improvement [ 29 ], and one was guided by an empowerment model [ 30 ].…”