New Model of Automated Patient-Reported Outcomes Applied in Atrial Fibrillation. (March 2019)

• Record Type: Journal Article
• Authors: Hussein, Ayman A.; Lindsay, Bruce; Madden, Ruth; Martin, David; Saliba, Walid I.; Tarakji, Khaldoun G.; Saqi, Bilal; Rausch, David J.; Dresing, Thomas; Callahan, Thomas; Chung, Mina K.; Baranowski, Bryan; Bhargava, Mandeep; Cantillon, Daniel; Rickard, John; Kanj, Mohamed; Tchou, Patrick; Wilkoff, Bruce L.; Nissen, Steven E.; Wazni, Oussama M.
• Is Part Of: Circulation. Volume 12:Number 3(2019)
• Publication Date: 2019-03
• Subjects: ablation -- atrial fibrillation -- automation -- hospitalization -- quality of life; Arrhythmia -- Periodicals; Heart -- Electric properties -- Periodicals; 616.128
• DOI: 10.1161/CIRCEP.118.006986
• Languages: English
• ISSNs: 1941-3149

Abstract

Abstract : Background: The value of patient-reported outcomes (PRO) is increasingly recognized in patient-centered care. Longitudinal data collection may be challenging and cost prohibitive. Automation of PRO collection may complement routine clinical follow-up, especially for procedures aiming to improve quality of life, such as atrial fibrillation (AF) ablation. Methods: We aimed to develop a fully automated platform to collect PRO and evaluate its first clinical application in a prospective cohort of AF ablation. The duration of follow-up and data availability were assessed with automated PRO and routine follow-up versus routine follow-up alone (primary outcome). Quality of life and healthcare utilization (secondary outcomes) by PRO were assessed. Results: Between 2013 and 2016, 2175 patients were eligible to receive 10 903 PRO assessment invitations, and the automated platform sent all invitations as programmed. More follow-up assessments were obtained with automated PRO and routine follow-up compared with routine follow-up alone (12 859 versus 10 248; P <0.0001) which allowed longer duration of follow-up (378 versus 217 days, 74% increase; P <0.0001). By automated PRO, a large number of disease-specific variables were collected and showed improvement in quality of life (baseline median AF symptom severity score AFSSS of 12 [6–18] and ranged between 2 and 3 on subsequent assessments; P <0.0001). This improvement was also true for each of the AFSSS individual components ( P <0.0001). In PRO, there was a significant reduction in AF burden (such as frequency and duration of episodes; P <0.0001) and associated healthcare utilization (including emergency visits and hospitalizations; P <0.0001) after the ablation procedures. Conclusions: A fully automated system for PRO collection enhanced clinical follow-up and allowed collection of disease-specific data when applied in a prospective cohort of AF ablation. Abstract : Supplemental Digital Content is available in the text.