TY - JOUR
T1 - Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL)
T2 - A Feasibility Study of a Cross-Sectoral Shared-Care Model
AU - Ladegaard, Caroline Thorup
AU - Bamberg, Carsten
AU - Aalling, Mathias
AU - Jensen, Dorthea Marie
AU - Kamstrup-Larsen, Nina
AU - Madsen, Christoffer Valdorff
AU - Kamil, Sadaf
AU - Gudbergsen, Henrik
AU - Saxild, Thomas
AU - Schiotz, Michaela Louise
AU - Grew, Julie
AU - Castillo, Luana Sandoval
AU - Frolich, Anne
AU - Dominguez, Helena
PY - 2022
Y1 - 2022
N2 - Introduction: Atrial fibrillation (AF) management in primary care often requires a referral to cardiology clinics, which can be strenuous for frail patients. We developed "cardio-share" (CS), a new cross-sector collaboration model, to ease this process. General practitioners (GPs) can use a compact Holter monitor (C3 from Cortrium) to receive remote advice from the cardiologist. Objective: To test the feasibility and acceptability of the CS model to manage suspected AF in frail elderly patients. Methods: We used a mixed methods design, including the preparation of qualitative semistructured interviews of GPs and nurses. Results: Between MAR-2019 and FEB-2020, 54 patients were consulted through the CS model, of whom 35 underwent C3 Holter monitoring. The time from referral to a final Holter report was shortened from a mean (SD) of 117 (45) days in usual care to 30 days (13) with the CS model. Furthermore, 90% of the patients did not need to attend visits at the cardiology clinic. The GPs and nurses highlighted the ease of using the C3 monitor. Their perception was that patients were confident in the GPs' collaboration with cardiologists. Conclusions: The CS model using a C3 monitor for AF is both feasible and seems acceptable to GPs. The elapsed time from referral to the Holter report performed for the diagnosis was significantly reduced.
AB - Introduction: Atrial fibrillation (AF) management in primary care often requires a referral to cardiology clinics, which can be strenuous for frail patients. We developed "cardio-share" (CS), a new cross-sector collaboration model, to ease this process. General practitioners (GPs) can use a compact Holter monitor (C3 from Cortrium) to receive remote advice from the cardiologist. Objective: To test the feasibility and acceptability of the CS model to manage suspected AF in frail elderly patients. Methods: We used a mixed methods design, including the preparation of qualitative semistructured interviews of GPs and nurses. Results: Between MAR-2019 and FEB-2020, 54 patients were consulted through the CS model, of whom 35 underwent C3 Holter monitoring. The time from referral to a final Holter report was shortened from a mean (SD) of 117 (45) days in usual care to 30 days (13) with the CS model. Furthermore, 90% of the patients did not need to attend visits at the cardiology clinic. The GPs and nurses highlighted the ease of using the C3 monitor. Their perception was that patients were confident in the GPs' collaboration with cardiologists. Conclusions: The CS model using a C3 monitor for AF is both feasible and seems acceptable to GPs. The elapsed time from referral to the Holter report performed for the diagnosis was significantly reduced.
KW - sensor Holter monitoring
KW - atrial fibrillation
KW - health professionals
KW - frail elderly patients
KW - cross-sector collaboration
KW - QUALITATIVE CONTENT-ANALYSIS
KW - AORTIC-VALVE-REPLACEMENT
KW - RISK
KW - WARFARIN
KW - STROKE
KW - COMMUNITY
KW - SURGERY
U2 - 10.3390/ijerph19127383
DO - 10.3390/ijerph19127383
M3 - Journal article
C2 - 35742632
VL - 19
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
SN - 1661-7827
IS - 12
M1 - 7383
ER -