Nurse-led atrial fibrillation clinics in primary health care: a review of the evidence.

IF 1.8 3区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Maria Dahlberg, Ulf Jakobsson
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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects.

Aim: To review the scientific literature regarding the effects of nurse-led AF clinics in PHC.

Methods: A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles.

Results: Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments.

Conclusions: Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.

初级卫生保健中护士主导的房颤诊所:证据综述。
背景:房颤(AF)是世界上最常见的心律失常,大多数房颤患者在初级保健中接受治疗。为了尽量减少住院和到急诊科就诊,二级保健和初级保健采用了护士领导的护理。然而,尽管护士主导的护理在近十年前就开始在初级保健中开展,ESC指南也推荐以患者为中心的综合护理,包括初级保健,但似乎缺乏关于其效果的科学证据。目的:回顾有关护士主导的房颤门诊在PHC中的作用的科学文献。方法:对Medline/Cinahl的科学文献进行系统综述。两名审稿人独立评估了检索到的文章。结果:仅发现一项研究调查了护士主导的结构化房颤管理在PHC中的有效性。研究结果显示了积极的影响;与常规护理相比,全因死亡率降低45%,护士主导护理的全因住院人数显著降低。有几项研究分析了二级护理机构中护士主导的af护理的效果,但在初级保健机构中只有一项研究。结果主要表明,二级护理中护士主导的护理降低了死亡率、住院率和急诊科就诊率。结论:尽管只有一项研究关注PHC,但该综述表明护士主导的护理对房颤患者有积极作用。然而,这些结果仅仅是基于在住院治疗中进行的研究。因此,对于初级保健中护士主导的房颤诊所,还不能得出确切的结论,这一领域显然需要更多的研究。
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
CiteScore
3.20
自引率
19.00%
发文量
47
审稿时长
>12 weeks
期刊介绍: Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice. Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include: • Clinical family medicine • Epidemiological research • Qualitative research • Health services research.
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