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Published in: BMC Cardiovascular Disorders 1/2013

Open Access 01-12-2013 | Research article

Patient perspective on the management of atrial fibrillation in five European countries

Authors: Ameet Bakhai, Anna Sandberg, Thomas Mittendorf, Wolfgang Greiner, André MS Oberdiek, Patrizia Berto, Edith Franczok, Trudie Lobban, Jose L Zamorano

Published in: BMC Cardiovascular Disorders | Issue 1/2013

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Abstract

Background

Long-term management of chronic conditions, such as atrial fibrillation (AF), require frequent interactions with the healthcare systems. The multinational EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) was conducted to investigate patient satisfaction with AF management in different of five European healthcare systems at a time of changing treatment paradigms for stroke prophylaxis, prior to the advent of newer oral anticoagulants.

Methods

Adults (>18 years) were recruited at random from the total populations of France, Germany, Italy, Spain and the UK using a randomized telephone dialling system. At least 300 respondents per country reporting to have a diagnosis of AF or receiving oral anticoagulation therapy for suspected AF or to have a heart rhythm disturbance completed a structured telephone interview.

Results

Most respondents were satisfied with their treatment for AF over the previous 12 months, with 85.5% (n = 1289) rating their care as good or better. Suboptimal clinical practices, however, were identified in several key areas. Coordination of primary and secondary care and a lack of patient engagement and support were particular issues, especially for those patients likely to have extensive contact with their healthcare system.

Conclusions

In the context of Europe-wide guidelines for management of AF, most patients with AF were satisfied with their care, but for a greater proportion of patients, some aspects are unsatisfactory. Patient-centred surveys, such as the EUPS-AF, are crucial for understanding the factors that contribute to patient satisfaction and compliance with long-term treatment for chronic conditions.
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Literature
1.
go back to reference Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, et al: Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010, 31: 2369-2429.CrossRefPubMed Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, et al: Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010, 31: 2369-2429.CrossRefPubMed
2.
go back to reference Davis RC, Hobbs FD, Kenkre JE, Roalfe AK, Iles R, Lip GY, Davies MK: Prevalence of atrial fibrillation in the general population and in high-risk groups: the ECHOES study. Europace. 2012, 14: 1553-1559. 10.1093/europace/eus087.CrossRefPubMed Davis RC, Hobbs FD, Kenkre JE, Roalfe AK, Iles R, Lip GY, Davies MK: Prevalence of atrial fibrillation in the general population and in high-risk groups: the ECHOES study. Europace. 2012, 14: 1553-1559. 10.1093/europace/eus087.CrossRefPubMed
3.
go back to reference Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, et al: ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011, 2011 (123): e269-e367.CrossRef Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Kay GN, Le Huezey JY, Lowe JE, et al: ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2011, 2011 (123): e269-e367.CrossRef
4.
go back to reference Institute of Medicine: Crossing the quality chasm: a new health system for the twenty-first century. 2001, Washington: National Academy Press, 1-8. Institute of Medicine: Crossing the quality chasm: a new health system for the twenty-first century. 2001, Washington: National Academy Press, 1-8.
5.
go back to reference Porter ME: What is value in health care?. N Engl J Med. 2010, 363: 2477-2481. 10.1056/NEJMp1011024.CrossRefPubMed Porter ME: What is value in health care?. N Engl J Med. 2010, 363: 2477-2481. 10.1056/NEJMp1011024.CrossRefPubMed
6.
go back to reference Schoen C, Osborn R, How SK, Doty MM, Peugh J: In chronic condition: experiences of patients with complex health care needs, in eight countries, 2008. Health Aff (Millwood). 2008, 28: w1-w16.CrossRef Schoen C, Osborn R, How SK, Doty MM, Peugh J: In chronic condition: experiences of patients with complex health care needs, in eight countries, 2008. Health Aff (Millwood). 2008, 28: w1-w16.CrossRef
7.
go back to reference MacLean S, Mulla S, Akl EA, Jankowski M, Vandvik PO, Ebrahim S, McLeod S, Bhatnagar N, Guyatt GH: Patient values and preferences in decision making for antithrombotic therapy: a systematic review: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012, 141: e1S-e23S.CrossRefPubMedPubMedCentral MacLean S, Mulla S, Akl EA, Jankowski M, Vandvik PO, Ebrahim S, McLeod S, Bhatnagar N, Guyatt GH: Patient values and preferences in decision making for antithrombotic therapy: a systematic review: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012, 141: e1S-e23S.CrossRefPubMedPubMedCentral
8.
go back to reference Protheroe J, Fahey T, Montgomery AA, Peters TJ: The impact of patients’ preferences on the treatment of atrial fibrillation: observational study of patient based decision analysis. BMJ. 2000, 320: 1380-1384. 10.1136/bmj.320.7246.1380.CrossRefPubMedPubMedCentral Protheroe J, Fahey T, Montgomery AA, Peters TJ: The impact of patients’ preferences on the treatment of atrial fibrillation: observational study of patient based decision analysis. BMJ. 2000, 320: 1380-1384. 10.1136/bmj.320.7246.1380.CrossRefPubMedPubMedCentral
9.
go back to reference Schoen C, Osborn R, Huynh PT, Doty M, Zapert K, Peugh J, Davis K: Taking the pulse of health care systems: experiences of patients with health problems in six countries. Health Aff (Millwood). 2005, 5 (Suppl Web Exclusives): 509-525. Schoen C, Osborn R, Huynh PT, Doty M, Zapert K, Peugh J, Davis K: Taking the pulse of health care systems: experiences of patients with health problems in six countries. Health Aff (Millwood). 2005, 5 (Suppl Web Exclusives): 509-525.
10.
go back to reference Schoen C, Osborn R, Squires D, Doty M, Pierson R, Applebaum S: New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated. Health Aff (Millwood). 2011, 30: 2437-2448. 10.1377/hlthaff.2011.0923.CrossRef Schoen C, Osborn R, Squires D, Doty M, Pierson R, Applebaum S: New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated. Health Aff (Millwood). 2011, 30: 2437-2448. 10.1377/hlthaff.2011.0923.CrossRef
11.
go back to reference Harris D, Grimshaw J, Lemon J, Russell IT, Taylor R: The use of a computer-assisted telephone interview technique in a general practice research study. Fam Pract. 1993, 10: 454-458. 10.1093/fampra/10.4.454.CrossRefPubMed Harris D, Grimshaw J, Lemon J, Russell IT, Taylor R: The use of a computer-assisted telephone interview technique in a general practice research study. Fam Pract. 1993, 10: 454-458. 10.1093/fampra/10.4.454.CrossRefPubMed
12.
go back to reference Department of Health: National Service Framework for Coronary Heart Disease. Book National Service Framework for Coronary Heart Disease. 2000, City: Department of Health, 1-128. Department of Health: National Service Framework for Coronary Heart Disease. Book National Service Framework for Coronary Heart Disease. 2000, City: Department of Health, 1-128.
13.
go back to reference Department of Health Coronary Heart Disease Team: National Service Framework for Coronary Heart Disease – Chapter Eight: Arrhythmias and Sudden Cardiac Death. Book National Service Framework for Coronary Heart Disease – Chapter Eight: Arrhythmias and Sudden Cardiac Death. 2005, City: Department of Health, 1-20. Department of Health Coronary Heart Disease Team: National Service Framework for Coronary Heart Disease – Chapter Eight: Arrhythmias and Sudden Cardiac Death. Book National Service Framework for Coronary Heart Disease – Chapter Eight: Arrhythmias and Sudden Cardiac Death. 2005, City: Department of Health, 1-20.
15.
go back to reference Lobban TCA, Camm JA: Patient associations as stakeholders: a valuable partner for facilitating access to therapy. Europace. 2011, 13: 21-24.CrossRef Lobban TCA, Camm JA: Patient associations as stakeholders: a valuable partner for facilitating access to therapy. Europace. 2011, 13: 21-24.CrossRef
16.
go back to reference Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, et al: European guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2012, Epub ahead of print Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, et al: European guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2012, Epub ahead of print
17.
go back to reference Wickizer TM, Franklin G, Fulton-Kehoe D, Turner JA, Mootz R, Smith-Weller T: Patient satisfaction, treatment experience, and disability outcomes in a population-based cohort of injured workers in Washington State: implications for quality improvement. Health Serv Res. 2004, 39: 727-748. 10.1111/j.1475-6773.2004.00255.x.CrossRefPubMedPubMedCentral Wickizer TM, Franklin G, Fulton-Kehoe D, Turner JA, Mootz R, Smith-Weller T: Patient satisfaction, treatment experience, and disability outcomes in a population-based cohort of injured workers in Washington State: implications for quality improvement. Health Serv Res. 2004, 39: 727-748. 10.1111/j.1475-6773.2004.00255.x.CrossRefPubMedPubMedCentral
18.
go back to reference Borgermans L, Goderis G, Van Den Broeke C, Verbeke G, Carbonez A, Ivanova A, Mathieu C, Heyrman J: Patients’ experiences with patient-centred care are associated with documented outcome of care indicators for diabetes: findings from the Leuven Diabetes Project. Int J Care Pathw. 2011, 15: 65-75. 10.1258/jicp.2011.011m27.CrossRef Borgermans L, Goderis G, Van Den Broeke C, Verbeke G, Carbonez A, Ivanova A, Mathieu C, Heyrman J: Patients’ experiences with patient-centred care are associated with documented outcome of care indicators for diabetes: findings from the Leuven Diabetes Project. Int J Care Pathw. 2011, 15: 65-75. 10.1258/jicp.2011.011m27.CrossRef
19.
go back to reference Aliot E, Breithardt G, Brugada J, Camm J, Lip GY, Vardas PE, Wagner M: An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality. Europace. 2010, 12: 626-633. 10.1093/europace/euq109.CrossRefPubMedPubMedCentral Aliot E, Breithardt G, Brugada J, Camm J, Lip GY, Vardas PE, Wagner M: An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality. Europace. 2010, 12: 626-633. 10.1093/europace/euq109.CrossRefPubMedPubMedCentral
20.
go back to reference Devereaux PJ, Anderson DR, Gardner MJ, Putnam W, Flowerdew GJ, Brownell BF, Nagpal S, Cox JL: Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. BMJ. 2001, 323: 1-7. 10.1136/bmj.323.7303.1.CrossRef Devereaux PJ, Anderson DR, Gardner MJ, Putnam W, Flowerdew GJ, Brownell BF, Nagpal S, Cox JL: Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. BMJ. 2001, 323: 1-7. 10.1136/bmj.323.7303.1.CrossRef
21.
go back to reference Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P: 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J. 2012, 33: 2719-2747.CrossRefPubMed Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P: 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J. 2012, 33: 2719-2747.CrossRefPubMed
Metadata
Title
Patient perspective on the management of atrial fibrillation in five European countries
Authors
Ameet Bakhai
Anna Sandberg
Thomas Mittendorf
Wolfgang Greiner
André MS Oberdiek
Patrizia Berto
Edith Franczok
Trudie Lobban
Jose L Zamorano
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2013
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-13-108

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