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Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model

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...

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Autores principales: Ladegaard, Caroline Thorup, Bamberg, Carsten, Aalling, Mathias, Jensen, Dorthea Marie, Kamstrup-Larsen, Nina, Madsen, Christoffer Valdorff, Kamil, Sadaf, Gudbergsen, Henrik, Saxild, Thomas, Schiøtz, Michaela Louise, Grew, Julie, Castillo, Luana Sandoval, Frølich, Anne, Domínguez, Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9223795/
https://www.ncbi.nlm.nih.gov/pubmed/35742632
http://dx.doi.org/10.3390/ijerph19127383
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author Ladegaard, Caroline Thorup
Bamberg, Carsten
Aalling, Mathias
Jensen, Dorthea Marie
Kamstrup-Larsen, Nina
Madsen, Christoffer Valdorff
Kamil, Sadaf
Gudbergsen, Henrik
Saxild, Thomas
Schiøtz, Michaela Louise
Grew, Julie
Castillo, Luana Sandoval
Frølich, Anne
Domínguez, Helena
author_facet Ladegaard, Caroline Thorup
Bamberg, Carsten
Aalling, Mathias
Jensen, Dorthea Marie
Kamstrup-Larsen, Nina
Madsen, Christoffer Valdorff
Kamil, Sadaf
Gudbergsen, Henrik
Saxild, Thomas
Schiøtz, Michaela Louise
Grew, Julie
Castillo, Luana Sandoval
Frølich, Anne
Domínguez, Helena
author_sort Ladegaard, Caroline Thorup
collection PubMed
description 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.
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spelling pubmed-92237952022-06-24 Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model Ladegaard, Caroline Thorup Bamberg, Carsten Aalling, Mathias Jensen, Dorthea Marie Kamstrup-Larsen, Nina Madsen, Christoffer Valdorff Kamil, Sadaf Gudbergsen, Henrik Saxild, Thomas Schiøtz, Michaela Louise Grew, Julie Castillo, Luana Sandoval Frølich, Anne Domínguez, Helena Int J Environ Res Public Health Article 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. MDPI 2022-06-16 /pmc/articles/PMC9223795/ /pubmed/35742632 http://dx.doi.org/10.3390/ijerph19127383 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ladegaard, Caroline Thorup
Bamberg, Carsten
Aalling, Mathias
Jensen, Dorthea Marie
Kamstrup-Larsen, Nina
Madsen, Christoffer Valdorff
Kamil, Sadaf
Gudbergsen, Henrik
Saxild, Thomas
Schiøtz, Michaela Louise
Grew, Julie
Castillo, Luana Sandoval
Frølich, Anne
Domínguez, Helena
Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title_full Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title_fullStr Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title_full_unstemmed Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title_short Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model
title_sort reaching frail elderly patients to optimize diagnosis and management of atrial fibrillation (reafel): a feasibility study of a cross-sectoral shared-care model
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9223795/
https://www.ncbi.nlm.nih.gov/pubmed/35742632
http://dx.doi.org/10.3390/ijerph19127383
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