A pilot study of the quality of care of atrial fibrillation in Irish general practice.

IF 2.4 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Family practice Pub Date : 2024-10-08 DOI:10.1093/fampra/cmae001

Sarah McErlean, John Broughan, Geoff McCombe, Ronan Fawsitt, Mark Ledwidge, Walter Cullen, Joe Gallagher

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引用次数: 0

Abstract

Background: Worldwide, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults and poses a significant burden to patients, physicians, and healthcare systems. We developed a quality of care score based on the Atrial Fibrillation Better Care pathway recommended by the European Society of Cardiology and the European Heart Rhythm Association guidelines. This is a 14-point score that we have termed the MAGIC score(Management of Atrial Fibrillation in Integrated Care and General Practice).

Objective: The objective of this pilot study was to develop and test a quality of care score for patients with permanent AF in general practice.

Methods: An observational cross-sectional pilot study was undertaken. Proportionate sampling was used across 11 practices from the Ireland East practice-based research network. The GPs completed a report form on each patient by undertaking a retrospective chart review. Eleven practices participated with a total of 1855 patients with AF. We received data on 153 patients.

Results: The main findings were that no patient met all 14 guideline based recommendations. The mean MAGIC score was 11.3. Points were most commonly deducted because the creatinine clearance and HAS-BLED score were not recorded, and the patient was not on the correct dose of oral anti-coagulation.

Conclusion: This study demonstrates the feasibility of using a quality of care score to measure the quality of AF management in general practice. This scoring system, which is based on internationally recognized quality of care markers, highlights key areas that can be targeted with quality improvement intervention.

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爱尔兰全科医生心房颤动护理质量试点研究。

背景：在全球范围内，心房颤动（房颤）是成人中最常见的持续性心律失常，给患者、医生和医疗保健系统带来了沉重负担。我们根据欧洲心脏病学会和欧洲心脏节律协会指南推荐的心房颤动更好护理路径制定了护理质量评分。这是一个 14 分的评分，我们将其称为 MAGIC 评分（综合护理和全科实践中的心房颤动管理）：本试点研究的目的是为全科医生中的永久性房颤患者制定并测试护理质量评分：方法：开展一项观察性横断面试点研究。在爱尔兰东部以实践为基础的研究网络中的 11 家诊所按比例抽样。全科医生通过回顾性病历审查，为每位患者填写一份报告表。共有 11 家诊所参与了这项研究，共有 1855 名房颤患者。我们收到了 153 名患者的数据：主要结果是，没有一名患者符合所有 14 项基于指南的建议。平均 MAGIC 得分为 11.3 分。扣分最常见的原因是未记录肌酐清除率和 HAS-BLED 评分，以及患者未使用正确剂量的口服抗凝药：本研究证明了使用护理质量评分来衡量全科心房颤动管理质量的可行性。该评分系统以国际公认的护理质量指标为基础，突出了可进行质量改进干预的关键领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Family practice 医学-医学：内科

CiteScore

4.30

自引率

9.10%

发文量

144

审稿时长

4-8 weeks

期刊介绍： Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries. Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration. The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.