New Tool Unveils Common Medical Conditions in Atrial Fibrillation Patients
The management of elderly atrial fibrillation patients with multiple conditions will be improved using a newly developed software tool designed by the EU-funded and ESC-coordinated EHRA-PATHS consortium. The latest updates on this clinical innovation are presented at the scientific congress of the European Society of Cardiology (ESC).
Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million people worldwide. Patients with atrial fibrillation have an average of five co-existing conditions including high blood pressure, coronary artery disease, heart failure, obesity, and chronic kidney disease.
‘People with atrial fibrillation have an average of five additional medical conditions including high blood pressure, coronary artery disease, and chronic kidney disease.’
These comorbidities harm survival.4 In addition, three-quarters of atrial fibrillation patients take at least five medications. EHRA-PATHS is a multicentre international project focused on integrated care for patients with atrial fibrillation and at least one additional chronic condition.
The multidisciplinary program is being coordinated by the ESC and the European Heart Rhythm Association (EHRA). An EHRA-PATHS survey of healthcare professionals previously reported that the lack of an integrated care model was hindering referrals to specialist services for atrial fibrillation comorbidities.
Atrial Fibrillation Patients Have Average of Five Additional Medical Conditions Results of patient interviews, presented for the first time at EHRA 2023, highlighted the need for integrated care and interprofessional working to optimize the health of patients with multimorbid atrial fibrillation.
The in-depth interviews included 30 atrial fibrillation patients with two or more additional conditions from Belgium, Greece, Poland, Spain, and the Netherlands. The average age was 73 years and 37% were women.
The most common comorbidity was high blood pressure, followed by high cholesterol, obesity, hypothyroidism, and diabetes. Interviewees stressed the need for better communication between primary care and hospitals. Some had multiple appointments at different locations and were frustrated with the unintegrated care.
While respondents had some knowledge about the relationship between comorbidities and atrial fibrillation and were motivated to adjust, they lacked formal education on how to implement and maintain lifestyle changes.
EHRA-PATHS investigators have defined 22 comorbidities that are relevant in patients with atrial fibrillation. For each, the consortium has created concise care pathways to check for or exclude whether a given comorbidity is present, to guide its further evaluation, and to ensure its effective management.
The care pathways are now being integrated with a software tool that will assist healthcare personnel to evaluate atrial fibrillation patients systematically and comprehensively. The software will be evaluated in a clinical study involving 65 hospitals in 14 European countries.
To establish a baseline picture, in part one of the study, researchers will evaluate the management (assessment and treatment) of risk factors and comorbidities in approximately 1,300 patients aged 65 years and older with newly diagnosed atrial fibrillation.
Part two will be a randomized controlled trial in 1,080 patients assessing whether allocation to the software tool improves the management of atrial fibrillation compared with usual care.
Developing such a standardized approach ensures that patients with atrial fibrillation receive evidenced-based therapies for the comorbidities that underlie or complicate their heart rhythm disorder.
Source: Eurekalert