Effects of nurse-led multidisciplinary team management on cardiovascular hospitalization and quality of life in patients with atrial fibrillation: Randomized controlled trial.

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Date: Mar. 2022
Publisher: Elsevier B.V.
Document Type: Report
Length: 529 words

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Keywords Atrial fibrillation; Hospitalization; Interdisciplinary; Mortality; Nursing care; Quality of life; Randomized controlled trial Abstract Background Atrial fibrillation is globally the most common sustained cardiac arrhythmia which increases patient morbidity and mortality, dramatically influencing well-being. Despite substantial efforts, an optimal clinical pathway for chronic atrial fibrillation management has yet to be developed. In recent practice, a multidisciplinary team management has been recommended for patients with atrial fibrillation. However, experiments exploring nurse-led multidisciplinary team management in chronic atrial fibrillation management relative to standard clinical management are still sparse and limited. Objective To evaluate the effects of a nurse-led multidisciplinary team approach on cardiovascular hospitalization and death, and quality of life in patients with atrial fibrillation. Design Randomized controlled trial. Setting The Cardiology Department of a tertiary referral hospital in Beijing, China. Participants Eligible patients diagnosed with atrial fibrillation who consented. Methods Subjects were randomly assigned into one of two Cardiology Units upon admission. Patients in the control group (n = 119) received usual care and those in the intervention group (n = 116) underwent a nurse-led multidisciplinary team approach. Follow-up lasted for 12 months. The primary endpoint was a composite of cardiovascular hospitalization and cardiovascular death. The secondary endpoint was the differences in the quality of life between the groups observed at 6 months and 12 months of follow-up, compared to the baseline data, as determined using a Chinese version of the Medical Outcome Study Short-Form 36 General Health Survey. Results Patients under intervention showed a fewer cardiovascular hospitalization (17 vs. 35, p = 0.006) than those receiving usual care. Discernible differences were also observed in rates of cardiovascular hospitalization between the two groups (hazard ratio: 2.115, 95% confidential interval: 1.228--3.643, log-rank = 6.746, p = 0.009). Quality of life was improved in both groups, but more so in the intervention group (scores, 588.0 [plus or minus] 106.0 vs. 519.1 [plus or minus] 120.7 at 6 months and 674.4 [plus or minus] 53.4 vs. 584.1 [plus or minus] 105.9 at 12 months; both p Conclusions Nurse-led multidisciplinary team management reduces cardiovascular hospitalization and improves quality of life in patients with atrial fibrillation, suggesting that this innovative management approach should be implemented in clinical practice. Registration number Chinese Clinical Trial Registry (ChiCTR1800018851). Author Affiliation: (a) College of Nursing, Capital Medical University, No. 10 You-an-men Wai Xi-tou-tiao, Feng-tai District, Beijing 100069, China (b) Department of Comprehensive Cardiovascular, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No. 7, Weiwu Road, Jinshui District, Zhengzhou, Henan, 450003, China (c) Department of Cardiology Center, Beijing Chaoyang Hospital, Capital Medical University, No. 8, South Road of Worker's Stadium, Chaoyang District, Beijing, 100020, China * Corresponding authors. Article History: Received 4 May 2021; Revised 9 December 2021; Accepted 10 December 2021 (footnote)1 These authors contributed equally to this work. Byline: Hui Yan (a,1), Yi-Xiu Du (a,b,1), Fang-Qin Wu [wufangqin@ccmu.edu.cn] (a,*), Xiao-Ying Lu [luxiaoying0408@163.com] (c,*), Ru-Ming Chen [jiwangwang75@sina.com] (c), Yu Zhang [2319293739@qq.com] (c)

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Gale Document Number: GALE|A695646045