An Atrial Fibrillation Transitions of Care Clinic Improves Atrial Fibrillation Quality Metrics
An Atrial Fibrillation Transitions of Care Clinic Improves Atrial Fibrillation Quality Metrics
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DOI：
10.1016/j.jacep.2019.09.001
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发表时间：
2020-01-01
影响因子：
7
通讯作者：
Gehi, Anil K.
中科院分区：
文献类型：
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作者：
Abadie, Bryan Q.;Hansen, Benjamin;Gehi, Anil K.
结论本研究旨在评估房颤（AF）特异性临床是否与改善对美国心脏病学会（ACC）/美国心脏协会（AHA）临床表现和质量指标的依从性相关，这些指标适用于AF或房扑成人患者。一个AF专门的诊所开发，以减少AF入院，但也可能与改善quality of care.METHODS这一回顾性研究比较坚持ACC/AHA措施的患者谁提出的AF之间的急诊室出院到一个典型的门诊预约和出院到一个专门的AF过渡诊所运行的先进的做法提供者和心脏病专家的监督。结果对照组78例，干预组160例。转诊到专科诊所的患者更有可能进行中风风险评估和记录（99% vs. 26%; p < 0.01）;处方适当抗凝治疗（97% vs. 88%; p 0.03）;并筛查合并症，如吸烟（100% vs. 14%; p < 0.01），饮酒（92% vs. 60%; p < 0.01），阻塞性陡峭呼吸暂停（90% vs. 13%; p < 0.01），并且不太可能处方抗凝剂和抗血小板药物的不适当组合（1% vs. 9%; p < 0.01）.结论：房颤专科门诊与提高成人房颤患者对ACC/AHA临床表现和质量指标的依从性相关。
OBJECTIVES This study sought to assess whether an atrial fibrillation (AF)-spedfic clinic is associated with improved adherence to American College of Cardiology (ACC)/American Heart Association (AHA) clinical performance and quality measures for adults with AF or atrial flutter.BACKGROUND There are significant gaps in care of patients with AF, including underprescription of anticoagulation and treatment of AF risk factors. An AF specialized clinic was developed to reduce admissions for AF but may also be assodated with improved quality of care.METHODS This retrospective study compared adherence to ACC/AHA measures for patients who presented to the emergency department for AF between those discharged to a typical outpatient appointment and those discharged to a specialized AF transitions clinic run by an advanced practice provider and supervised by a cardiologist. Screening and treatment for common AF risk factors was also assessed.RESULTS The study enrolled 78 patients into the control group and 160 patients into the intervention group. Patients referred to the specialized clinic were more likely to have stroke risk assessed and documented (99% vs. 26%; p < 0.01); be prescribed appropriate anticoagulation (97% vs. 88%; p 0.03); and be screened for comorbidities such as tobacco use (100% vs. 14%; p < 0.01), alcohol use (92% vs. 60%; p < 0.01), and obstructive steep apnea (90% vs. 13%; p < 0.01) and less likely to be prescribed an inappropriate combination of anticoagulant and antiplatelet medications (1% vs. 9%; p < 0.01).CONCLUSIONS An AF specialized clinic was associated with improved adherence to ACC/AHA clinical performance and quality measures for adult patients with AF. (C) 2020 by the American College of Cardiology Foundation.