TY - JOUR

T1 - Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL)

T2 - A Feasibility Study of a Cross-Sectoral Shared-Care Model

AU - Ladegaard, Caroline Thorup

AU - Bamberg, Carsten

AU - Aalling, Mathias

AU - Jensen, Dorthea Marie

AU - Kamstrup-Larsen, Nina

AU - Madsen, Christoffer Valdorff

AU - Kamil, Sadaf

AU - Gudbergsen, Henrik

AU - Saxild, Thomas

AU - Schiotz, Michaela Louise

AU - Grew, Julie

AU - Castillo, Luana Sandoval

AU - Frolich, Anne

AU - Dominguez, Helena

PY - 2022

Y1 - 2022

N2 - Introduction: Atrial fibrillation (AF) management in primary care often requires a referral to cardiology clinics, which can be strenuous for frail patients. We developed "cardio-share" (CS), a new cross-sector collaboration model, to ease this process. General practitioners (GPs) can use a compact Holter monitor (C3 from Cortrium) to receive remote advice from the cardiologist. Objective: To test the feasibility and acceptability of the CS model to manage suspected AF in frail elderly patients. Methods: We used a mixed methods design, including the preparation of qualitative semistructured interviews of GPs and nurses. Results: Between MAR-2019 and FEB-2020, 54 patients were consulted through the CS model, of whom 35 underwent C3 Holter monitoring. The time from referral to a final Holter report was shortened from a mean (SD) of 117 (45) days in usual care to 30 days (13) with the CS model. Furthermore, 90% of the patients did not need to attend visits at the cardiology clinic. The GPs and nurses highlighted the ease of using the C3 monitor. Their perception was that patients were confident in the GPs' collaboration with cardiologists. Conclusions: The CS model using a C3 monitor for AF is both feasible and seems acceptable to GPs. The elapsed time from referral to the Holter report performed for the diagnosis was significantly reduced.

AB - Introduction: Atrial fibrillation (AF) management in primary care often requires a referral to cardiology clinics, which can be strenuous for frail patients. We developed "cardio-share" (CS), a new cross-sector collaboration model, to ease this process. General practitioners (GPs) can use a compact Holter monitor (C3 from Cortrium) to receive remote advice from the cardiologist. Objective: To test the feasibility and acceptability of the CS model to manage suspected AF in frail elderly patients. Methods: We used a mixed methods design, including the preparation of qualitative semistructured interviews of GPs and nurses. Results: Between MAR-2019 and FEB-2020, 54 patients were consulted through the CS model, of whom 35 underwent C3 Holter monitoring. The time from referral to a final Holter report was shortened from a mean (SD) of 117 (45) days in usual care to 30 days (13) with the CS model. Furthermore, 90% of the patients did not need to attend visits at the cardiology clinic. The GPs and nurses highlighted the ease of using the C3 monitor. Their perception was that patients were confident in the GPs' collaboration with cardiologists. Conclusions: The CS model using a C3 monitor for AF is both feasible and seems acceptable to GPs. The elapsed time from referral to the Holter report performed for the diagnosis was significantly reduced.

KW - sensor Holter monitoring

KW - atrial fibrillation

KW - health professionals

KW - frail elderly patients

KW - cross-sector collaboration

KW - QUALITATIVE CONTENT-ANALYSIS

KW - AORTIC-VALVE-REPLACEMENT

KW - RISK

KW - WARFARIN

KW - STROKE

KW - COMMUNITY

KW - SURGERY

U2 - 10.3390/ijerph19127383

DO - 10.3390/ijerph19127383

M3 - Journal article

C2 - 35742632

VL - 19

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 12

M1 - 7383

ER -