Key needs, quality performance indicators and outcomes for patients with atrial fibrillation and multimorbidity: The AFFIRMO study

Background
Patients with atrial fibrillation (AF) often have concomitant long-term conditions that negatively impact their quality of life and the clinical management they receive. The AFFIRMO study aimed to identify the needs, quality performance indicators (QPIs), and outcomes relevant to patients, caregivers and healthcare professionals (HCPs) to improve the care of patients with AF.

Methods
An on-line survey to collect the key needs, QPIs, and outcomes relevant to patients with AF, their caregivers and HCPs, was distributed between May 2022 and January 2023 in five countries (UK, Italy, Denmark, Romania and Spain). Results from the on-line survey were discussed in a three-round Delphi process with international representatives of patients with AF, caregivers, and HCPs to determine the key needs, QPIs and outcomes for the management of patients with AF and multimorbidity.

Results
659 patients (47.2% males, mean (SD) age 70.9 (10.2) years), 201 caregivers (26.9% males, mean (SD) age: 58.3 (SD 15.2) years), and 445 HCPs (57.8% males, mean (SD) age 47.4 (10.6) years) participated in the survey. An initial list of 27 needs, 9 QPIs, and 17 outcomes were identified. Eight patients, two caregivers, and 11 HCPs participated in the Delphi process. Nineteen (70%) needs, 8 (89%) QPIs, and 13 (76%) outcomes reached “consensus in”, and were included in the final list.

Conclusions
The final key needs, QPIs and outcomes obtained from the Delphi process will inform the AFFIRMO clinical trial, which aims to test the iABC app which incorporates an empowerment toolbox for patients and their caregivers, providing information to improve patient engagement and empowerment to help improve the clinical and self-management of patients with AF in the context of multimorbidity.

Contributors

Donato Giuseppe Leo, Caterina Trevisan, Adele Ravelli, Trudie C. A. Lobban, Deirdre A. Lane

Publication

Journal: PLoS ONE
Volume: 19
Issue: 9
Pages: -
Year: 2024
DOI: 10.1371/journal.pone.0310106

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The AFFIRMO project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant agreement No 899871.


Health Area

Disease Category: Heart & circulation

Disease Name: Atrial fibrillation, Multimorbidity

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Management of care

Stakeholders Involved

- Clinical experts
- Consumers (patients)

Study Type

- Recommendations made

Method(s)

- Consensus meeting
- Delphi process
- GRADE (Grading of Recommendations Assessment, Development, and Evaluation) scale
- Survey

1) an international on-line survey open to patients, their caregivers, and HCPs distributed in five countries (UK, Italy, Spain, Denmark, Romania) participating in the AFFIRMO study
2) a Delphi process with international patients, caregivers, and HCP representatives.

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