Four interventions to enhance the care and treatment of individuals with atrial fibrillation were presented on 10 January 2011 at a press briefing hosted by The American College of Physicians Foundation’s initiative on atrial fibrillation and stroke prevention. The goal of the interventions is to address the needs of health care providers, patients and their caregivers, leading to improved health outcomes and reduced risk of stroke.
Barbara Schuster, co-chair of the initiative emphasised a critical consideration in determining the appropriate course of treatment to reduce stroke risk in patients with atrial fibrillation, she commented, “The patient with a few falls, who is at average falls risk and has a yearly stroke risk greater than or equal to two per cent, would have to fall more than 300 times a year for the harm from falls to exceed the benefits of anticoagulation. Only 50 to 64% of eligible patients with atrial fibrillation receive anticoagulation therapy.”
The four interventions are summarised as follows:
- “Afib–What you and your family need to know” is a booklet designed to enhance provider-patient communication around atrial fibrillation and empower atrial fibrillation patients and families with the knowledge to reduce stroke risk and live well with the condition.
- Three patient videos geared toward empowering patients to actively engage in their care have been produced and will be available to healthcare providers and patients.
- “A guide for the quality improvement professional and health system leadership” is a compendium of information and tools to create awareness of the impact of poor management of atrial fibrillation within health systems and empower leadership to take necessary action to improve the quality of care provided to the atrial fibrillation patient population.
- “Background information and anticoagulation decision support” is to be distributed to clinicians to improve clinician knowledge, skills and attitudes around atrial fibrillation and stroke risk reduction as well as assist in anticoagulation decision-making within their workflow in either the outpatient or inpatient setting.
The panel of the briefing featured members of the initiative including Samuel Z Goldhaber, professor of Medicine at the Harvard Medical School and director of the Brigham and Women’s Hospital Venous Thromboembolism Research Group; Barbara L Schuster, co-chair, Atrial Fibrillation Initiative National Steering Committee Chair, ACP Foundation Board of Trustees Campus dean, Georgia Health Sciences University, UGA Medical Partnership; and Doron Schneider, co-chair, Atrial Fibrillation Initiative National Steering Committee Medical Director, Center for Patient Safety and Healthcare Quality, Abington Memorial Hospital. These panel members discussed the development process for the interventions as well as dissemination and implementation strategies to maximise opportunities for adoption of the tool in the USA, which will be available in electronic and paper-format.
Initial outcomes of the evaluation conducted with patients were presented by Doron Schneider. Nearly every patient who evaluated the booklet stated that it provided helpful information. A majority of patients (65%) feel that having read the Guide they are more confident in their ability to talk to their health care providers about the various medicines that are right for their atrial fibrillation and are “very confident” that they can follow through on medical treatments they need to do at home.
In the coming weeks and months, the initiative will be driving awareness and adoption of the interventions throughout the United States. Members of the National Steering Committee will be working to inform major stakeholder organisations and ensure these tools reach their intended recipients.