Transitions in Atrial Fibrillation Care: A Systematic Review

Rush, Kathy L.; Burton, Lindsay; Ollivier, Rachel; Wilson, Ryan; Loewen, Peter; Janke, Robert; Schaab, Kira; Lukey, Alexandra; Galloway, Camille

doi:10.1016/j.hlc.2019.11.022

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Multiple layers of continuity are required to secure proper treatment after hospitalization in the context of atrial fibrillation, myocardial infarction, and coronary and valvular interventions. 3,4 The complexity of medical systems and the bureaucracy associated with hospital-community continuity, even in integrated systems such as the Clalit Health Organization, 5 can create gaps in drug therapy and information transfer during care transition. The role of community care in managing cardiovascular diseases is central.…”

mentioning

confidence: 99%

Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions

Hijazi

Karkabi²,

Feldman³

et al. 2022

Journal of Cardiovascular Pharmacology

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Treatment fragmentation between hospitals and the community can result in catastrophic outcomes; uninterrupted treatment with anticoagulant and platelet aggregation inhibitors is particularly important. We assessed the proportion and characteristics of patients who did not visit their primary community-based physician within 1 week of discharge from our department of cardiovascular medicine and the proportion that failed to procure essential drugs at the community pharmacy. We prospectively studied 423 patients who were discharged from our department. They were provided detailed explanations, tablets for 7 days, prescriptions, and a printed drug plan. We traced the time from discharge until a visit with a primary community-based physician, and the time until the procurement of medications, using our computerized community-hospital-integrated system. Complete data were available for 313 patients, of whom 220 were treated with anticoagulants or platelet aggregation inhibitors. For 175 patients, these drugs were initiated during index hospitalizations. Only 1 patient did not receive platelet aggregation inhibitors despite recommendations. Seventy-nine patients (25%) first visited their primary care physicians more than 1 week after discharge. Predictors for delayed visits were living alone (hazard ratio 1.91) and having an in-house caregiver (hazard ratio 2.01). In conclusion, all but 1 patient continued drug therapy after discharge from the hospital. The simple predischarge steps included patient education and provision of a 1-week supply of tablets and prescriptions. Treatment continuation was independent of visits to the community-based primary physician. Patients living alone or with an inhouse caregiver more often delayed visits to primary physicians yet continued relevant drug therapy.

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mentioning

confidence: 99%

Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions

Hijazi

Karkabi²,

Feldman³

et al. 2022

Journal of Cardiovascular Pharmacology

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Barriers to Guideline-Directed Anticoagulation in Patients With Atrial Fibrillation: New Approaches to an Old Problem

Bhat

Karthikeyan

Chen

et al. 2023

Canadian Journal of Cardiology

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Пути Повышения Приверженности К Терапии И Прогноз У Пациентов С Фибрилляцией Предсердий

Дешко¹,

Бойко²,

Ускова³

et al. 2021

Кардиология В Беларуси

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Фибрилляция предсердий (ФП) является одной из главных проблем современной кардиологии. Распространенность сердечно-сосудистых заболеваний в популяции, недостаточный контроль факторов риска с одной стороны, увеличение продолжительности жизни и расширение возможностей выявления аритмии с другой привели к значительному росту числа случаев ФП. Течение ФП осложняется развитием инсульта, системных эмболий, сердечной недостаточности, повышается риск внезапной сердечной смерти. Для предупреждения осложнений большинству пациентов требуется постоянный прием пероральной антикоагулянтной (ОАК) терапии, а также лечение сердечно-сосудистых и коморбидных заболеваний. Приверженность к терапии ОАК и контроль факторов риска инсульта и кровотечений являются важными условиями эффективности и безопасности лечения, однако у многих пациентов приверженность остается низкой. Причиной этому служит целый ряд факторов, как связанных с самим пациентом, так и зависящих от врача и системы здравоохранения. Представленный обзор посвящен обсуждению возможных путей повышения приверженности к терапии и их роли для улучшения прогноза у пациентов с ФП с фокусом на их обучение, интегрированную помощь, использование программных средств. Atrial fibrillation (AF) is one of the major concerns in current cardiology practice. High prevalence of cardiovascular diseases in the population and poor control of the risk factors, as well as the increase of life expectancy and improved arrhythmia detection resulted in continuous increase of the number of AF cases. Stroke and systemic embolism, heart failure, and increased risk of sudden cardiac death are the complications of AF clinical course. For the vast majority of AF patients, the continuous oral anticoagulation (OAC) is required. Management of cardiovascular and comorbid diseases is essential to prevent complications as well. Medication adherence and control of strokeand bleeding risk factors ensure effectiveness and safety of OAC. Nonetheless, adherence remains low in many patients. The latter depends on the patient-related factors. In addition, the impact of physician and health care system is notable. In the current review, we discuss possible approaches to improve adherence and their prognostic impact in patients with AF with the focus on patients’ education, integrated medical care, and use of software tools.

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Transitions in Atrial Fibrillation Care: A Systematic Review

Cited by 3 publications

References 38 publications

Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions

Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions

Barriers to Guideline-Directed Anticoagulation in Patients With Atrial Fibrillation: New Approaches to an Old Problem

Пути Повышения Приверженности К Терапии И Прогноз У Пациентов С Фибрилляцией Предсердий

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