A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation
Abstract
:1. Introduction
Objectives
- AF patient-reported outcomes, i.e., AF-related QoL, AF knowledge, medication adherence, patient satisfaction and depression; and
- AF patients’ clinical outcomes, i.e., cardiovascular hospitalisation and stroke incidence.
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.3. Participants
2.4. Sampling
2.5. Recruitment
2.6. Intervention
2.7. Outcome Measures and Data Collection
2.8. Data Analysis
2.9. Ethical Considerations
3. Results
3.1. Recruitment and Retention
3.2. Characteristics of Participants
3.3. Comparison of Patient-Reported and Clinical Outcomes between Timepoints T0 and T1
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Definitions | |
---|---|
Stable AF | Defined as stable if the patient had:
|
Complex comorbidity | Includes:
|
Sociodemographic Variables | AF Patients Included for 6-Month Comparison (n = 43) |
---|---|
Age (years), median (IQR) | 69 (64–74) |
Gender, n (%) | |
Male | 29 (67) |
Female | 14 (33) |
Ethnicity, n (%) | |
Chinese | 38 (88) |
Malay | 5 (12) |
Marital Status, n (%) | |
Married | 35 (81) |
Widowed | 7 (16) |
Single | 1 (2) |
Living arrangement, n (%) | |
Live with spouse and children | 16 (37) |
Live with spouse | 16 (37) |
Live with children | 8 (18) |
Live alone | 3 (7) |
Require caregiver, n (%) | 0 (0) |
Level of education, n (%) | |
Primary school | 14 (33) |
Secondary school | 20 (47) |
Junior College/Pre-University | 4 (9) |
University | 3 (7) |
Pre-primary/no education | 2 (5) |
Employment status, n (%) | |
Retired | 22 (51) |
Full-time | 13 (30) |
Part-time | 6 (14) |
Unemployed | 2 (5) |
Clinical Variables | AF Patients Included for 6-Month Comparison (n = 43) |
---|---|
Duration of AF (months), median (IQR) | 37.0 (16.0–84.0) |
CHA2DS2-VASc score, median (IQR) | 3.0 (2.0–4.0) |
HAS-BLED score, median (IQR) | 2.0 (2.0–3.0) |
Hypertension, n (%) | 37 (86) |
Type II DM, n (%) | 17 (40) |
Ischaemic heart disease, n (%) | 7 (16) |
Congestive heart failure, n (%) | 1 (2) |
Outcome Variables | Baseline (T0) (n = 43) | 6-Month (T1) (n = 43) | ||||
---|---|---|---|---|---|---|
Median (IQR) | Mean ± SD | Median (IQR) | Mean ± SD | Z a | p-Value | |
AF-specific QoL (AFEQT overall score) | 93.5 (88.0–96.3) | 90.0 ± 11.5 | 96.3 (91.7–98.1) | 94.7 ± 5.4 | −3.29 | 0.001 * |
AF knowledge (SGAFKS score) | 4.60 (2.50–6.20) | 4.54 ± 2.5 | 6.80 (5.60–8.60) | 6.91 ± 1.8 | −4.70 | <0.001 * |
Medication adherence | 1.00 (1.00–2.00) | 1.49 ± 0.506 | 1.00 (1.00–2.00) | 1.26 ± 0.441 | −2.67 | 0.008 * |
Patient satisfaction (PSQ overall score) | 4.00 (4.00–4.00) | 3.91 ± 0.366 | 4.00 (4.00–4.00) | 4.07 ± 0.258 | −2.33 | 0.020 * |
Depression (PHQ-9) | 0.00 (0.00–1.00) | 1.05 ± 1.59 | 0.00 (0.00–0.00) | 0.530 ± 1.44 | −2.87 | 0.004 * |
Baseline (T0)a (n = 43) | 6-Month (T1) (n = 43) | |||
---|---|---|---|---|
Outcome Variables | Median, Range | Median, Range | Zb | p-Value |
Cardiovascular hospitalisation | 0, 3 | 0, 0 | −1.63 | 0.102 |
Stroke incidence | 0, 0 | 0, 0 | 0.00 | 1.00 |
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Woo, B.F.Y.; Tam, W.W.S.; Rangpa, T.; Liau, W.F.; Nathania, J.; Lim, T.W. A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation. Int. J. Environ. Res. Public Health 2022, 19, 4467. https://doi.org/10.3390/ijerph19084467
Woo BFY, Tam WWS, Rangpa T, Liau WF, Nathania J, Lim TW. A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation. International Journal of Environmental Research and Public Health. 2022; 19(8):4467. https://doi.org/10.3390/ijerph19084467
Chicago/Turabian StyleWoo, Brigitte Fong Yeong, Wilson Wai San Tam, Taiju Rangpa, Wei Fong Liau, Jennifer Nathania, and Toon Wei Lim. 2022. "A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation" International Journal of Environmental Research and Public Health 19, no. 8: 4467. https://doi.org/10.3390/ijerph19084467