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Can J Cardiol. 2019 Jul;35(7):846-854. doi: 10.1016/j.cjca.2019.03.020. Epub 2019 Mar 30.

Home-Based Education and Learning Program for Atrial Fibrillation: Rationale and Design of the HELP-AF Study.

Author information

1
Centre for Heart Rhythm Disorders, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia.
2
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia; Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, Australia.
3
School of Public Health, The University of Adelaide, Adelaide, Australia.
4
Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, Australia.
5
Central Adelaide Local Health Network, Adelaide, Australia.
6
South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
7
Centre for Heart Rhythm Disorders, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia. Electronic address: prash.sanders@adelaide.edu.au.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is a growing global epidemic, with its prevalence expected to significantly rise over coming decades. AF poses a substantial burden on health care systems, largely due to hospitalizations. Home-based clinical characterization has demonstrated improved outcomes in cardiac populations, but its impact on AF remains poorly defined. To test this hypothesis in AF, we developed the Home-Based Education and Learning Program for Patients With Atrial Fibrillation (HELP-AF) study.

METHODS:

The HELP-AF study is a prospective multicentre randomized controlled trial that will recruit 620 patients presenting to hospital emergency departments (EDs) with symptomatic AF (ANZCTR Registration: ACTRN12611000607976). Patients will be randomized to either the HELP-AF intervention or usual care. The intervention consists of 2 home visits by a nurse or pharmacist trained in the structured educational visiting (SEV) method. Patients in the control group will receive usual discharge follow-up care.

RESULTS:

The primary endpoints are total unplanned hospital admissions and quality of life. Secondary endpoints include AF symptom severity and burden score; time to first hospital admission; total unplanned days in hospital; total AF-related hospital admissions (including atrial flutter); total cardiac and noncardiac hospital admissions; total AF- or atrial flutter-related; cardiac- and noncardiac-related ED presentations; and all-cause mortality. An economic evaluation will also be performed. Clinical endpoints will be adjudicated by independent blinded assessors. Follow-up will be at 24 months.

CONCLUSIONS:

This study will assess the efficacy of a home-based structured patient-centred educational intervention in patients with AF.

PMID:
31292083
DOI:
10.1016/j.cjca.2019.03.020

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