Disease understanding in patients newly diagnosed with atrial fibrillation. Issue 6 (8th August 2017)

• Record Type: Journal Article
• Authors: Kaufman, Brystana G; Kim, Sunghee; Pieper, Karen; Allen, Larry A; Gersh, Bernard J; Naccarelli, Gerald V; Ezekowitz, Michael D; Fonarow, Gregg C; Mahaffey, Kenneth W; Singer, Daniel E; Chan, Paul S; Freeman, James V; Ansell, Jack; Kowey, Peter R; Rieffel, James A; Piccini, Jonathan; Peterson, Eric; O'Brien, Emily C
• Is Part Of: Heart. Volume 104:Issue 6(2018)
• Page Start: 494
• Page End: 501
• Publication Date: 2017-08-08
• Subjects: Atrial Fibrillation -- Quality of Care -- Stroke Prevention -- Shared Decision Making; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2017-311800
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. Methods: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites. Patients were surveyed at the baseline and 6-month follow-up clinic visits using Likert scales. Results: Among 1004 baseline survey responses, patients' confidence in their understanding of rhythm control, ablation, anticoagulation and cardioversion was suboptimal, with 'high' understanding ranging from 8.5% for left atrial appendage closure to 71.3% for rhythm therapy. Of medical history and demographic factors, education level was the strongest predictor of reporting 'high' disease understanding. Among the 786 patients with 6-month survey data, significant increases in the proportion reporting high understanding were observed (p<0.05) only for warfarin and direct oral anticoagulants (DOACs). With the exception of ablation, high understanding for a given therapeutic option was not associated with increased use of that therapy at 6 months. Conclusions: About half of patients with new-onset AF understood the benefits of oral anticoagulant at the time of diagnosis and understanding improved over the first 6 months. However, understanding of AF treatment remains suboptimal at 6 months. Our results suggest a need for ongoing patient education. Clinical trial registration: Clinicaltrials.gov. Identifier: NCT01701817 .