Intensified Multifaceted Education Improves the Implementation of Standard Atrial Fibrillation Care in Elderly Patients with Atrial Fibrillation in Rural China.

Abstract

Background: Exploring an integrated care management model to effectively deliver the standardized management to atrial fibrillation (AF) elderlies in rural China.

Purpose: The objective of this study was to assess whether intensified multifaceted education (IME) targeting AF elderlies, their family members, and the village doctors (VD) can increase compliance for rural AF elderlies with integrated care based on the AF Better Care (ABC) pathway. Additionally, the capacity of VD to deliver integrated AF care was investigated.

Patients and methods: This is a self-controlled cohort study before and after IME, including AF patients aged ≥65 years identified in phase-I of The Jiangsu Province Rural Community AF Project. The IME model was defined as 12 months of continuous knowledge education on integrated care management of AF based on the ABC pathway, delivered to AF patients, their family members and the village doctors. AF knowledge evaluation from VD and compliance with the ABC pathway before and after the IME model were evaluated.

Results: A total of 810 AF patients (mean age 76.1 ± 5.9 years; 51.4% women) were enrolled. After 12 months, the AF knowledge score of VD was significantly improved [(65.0 ± 13.0) scores vs (53.1 ± 9.8) scores, P < 0.001]. Although the compliance of AF patients with the ABC pathway was improved statistically (4.3% vs 1.7%, P = 0.003), the absolute increase was small.

Conclusion: Although VD have the potential to serve as AF integrated care management providers, the impact of the IME model used to improve the standard AF care in rural elderly AF population was small.