European Journal of Cardiovascular Nursing最新文献

{"title":"Supportive care improves self-care management and knowledge of patients with heart failure and diabetes mellitus","authors":"K Philippou, N Vouri, A Malaktou, A Samara, M Kyriakou, S Avgousti, E Lambrinou","doi":"10.1093/eurjcn/zvae098.022","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.022","url":null,"abstract":"Introduction Heart failure (HF) and diabetes mellitus (DM) most of the times occur together, aggravating patients’ outcomes and the interaction of the two conditions, which is complex, make the application of effective management programs necessary, in order to improve patients’ outcomes. Purpose The aim of the current study was to evaluate the effectiveness of an individualized supportive care management program in patients with HF and DM, in order to improve patients’ self-management compared to the ‘usual’ care. Methods The current study is a sub-analysis of the randomized clinical trial named ‘SupportHeart’ using pragmatic methodology. It was consisted by the intervention group (IG) and the control group (CG). The study investigated the patients for a period of one year at 5 time points (in baseline, 1 month, 3 months, 6 months and 1 year). Self –care management was measured with the Greek versions of two tools: the ‘Self-care of Heart Failure Index’ (Gr-SCHFI) and the ‘European Heart Failure Self-Care Behavior Scale’ (Gr9EHFScBS). Linear Mixed Models Effects (LMME) were also used. Results The sample consisted of 121 patients with HF and DM and 66% were male patients. The Linear Mixed Model results have shown that there was a statistically significant effect of the intervention at all the time points after the intervention p < 0.001 in all the dimensions of the SCHFI; in the dimension of maintenance [1 month=2.6 (0.81, 4.4) p= 0.005, 3 months = 5.2 (3.4, 7.1) p < 0.001, 6 months = 8.1 (6.2, 10) p < 0.001, 1 year = 7.5 (5.7, 9.4) p < 0.001], on the management [1 month = 4.1(2.8, 5.4) p < 0.001, 3 months = 5.1 (3.8, 6.4) p < 0.001, 6 months = 7.5 (6.1, 8.9) p < 0.001, 1 year = 10 (8.7, 11) p < 0.001 and on the self-confidence [1 month =4.9 (3.4, 6.5) p < 0.001, 3 months = 7.8 (6.2, 9.4) p < 0.001, 6 months = 8.5 (6.9, 10) p < 0.001 and in 1 year = 9.1 (7.5, 11) p < 0.001]. The Linear Mixed Model results showed also a statistically significant effect of the intervention at all the time points after the intervention p < 0.001 in all the dimensions of the GR9EHFScBS: in the dimension of adhering to recommendations [1 month=1.5 (0.71, 2.3) p < 0.001, 3 months = 1.4 (0.59, 2.3) p < 0.001, 6 months=1.6 (0.69, 2.4) p < 0.001, in 1 year = 4.3 (3.5, 5.1) p < 0.001], on the fluid and sodium management [1 month = 2.3 (1.3, 3.2) p < 0.001, 3 months = 3.6 (2.6, 4.6) ) p < 0.001, 6 months = 4.5 (3.5, 5.5) p < 0.001, in 1 year = 6.4 (5.4, 7.4) ) p < 0.001 and on the physical activity and recognition of deteriorating symptoms [1 month = 2.6 (1.7, 3.6) p < 0.001, 3 months = 3.4 (2.4, 4.3) p < 0.001, 6 months = 3.9 (2.9, 4.9) p < 0.001, 1 year = 5.8 (4.8, 6.7) p < 0.001]. Conclusion Supportive care seems to be a promising concept for HF-DM management programs. The pragmatic methodology that","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"10 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery from severe cardio-respiratory failure: the trajectory of muscle mass, strength, function and health related quality of life","authors":"A Thomas, M Griffiths, A Kalakoutas, M Yates, J Sanders","doi":"10.1093/eurjcn/zvae098.086","DOIUrl":"https://doi.org/10.1093/eurjcn/zvae098.086","url":null,"abstract":"Background The impact of intensive care unit acquired weakness (ICUAW) is associated with reduced muscle mass, strength, function and health related quality of life (HRQoL). Patients suffering from severe cardio-respiratory failure are known to lose considerable muscle mass and strength in the first 7 days of admission to the intensive care unit (ICU). Furthermore, patients surviving critical illness have a considerable less HRQoL and physical function with long term outcomes such as inability to return to work being reported. However, more information regarding muscle loss and recovery is required when patients leave hospital. Currently there are no treatments for ICUAW as once the process is established management is supportive, such as physical therapy. Purpose We Sought to investigate the effects of severe cardio-respiratory failure, in patients receiving extra corporeal membrane oxygenation (ECMO), on ICUAW (including muscle mass, strength, function and HRQoL). Researching a real life model of ICUAW allows the observation of the loss of muscle mass and strength in the first stages of critical illness and severe cardio-respiratory failure. Methods Adults receiving ECMO for severe cardiorespiratory failure were included. Muscle mass was measured using ultrasound of the rectus femoris cross sectional area (RFcsa). Muscle strength was measured using hand held dynamometry for both hand held grip strength and isometric leg extension. HRQoL was measured using the EQ-5D-5L. Function was measured using the short physical performance battery (SPPB). Measurements were taken on day 0, day 7, ICU discharge, hospital discharge and at out-patient follow up. Results 17 patients were recruited with 10 patients completing follow up. Patients lost 24% muscle mass in the first 7 days of ICU admission and ECMO initiation, with muscle loss continuing up until ICU discharge. Contrary to the hypothesis only 50% of the patients were seen to recover muscle mass at follow up. Strength and function all considerably improved between ICU discharge and out patient follow up. The EQ5D crosswalk index supported this suggesting considerable functional improvement. Conclusion Patients in severe cardio-respiratory failure lose considerable muscle mass in the first 7 days of admission, with only 50% of these patients recovering the initial muscle loss at follow up. However, strength, function and HRQoL all improve following ICU discharge suggesting an element of functional recovery. Strength and function have shown to improve regardless of the status of the muscle mass. Therefore, given the advantages of the real-life model and novel findings, this could serve as a platform to assess muscle loss and recovery over a longer time frame continuing to build the understanding of the patients recovery trajectory from critical illness.Rectus Femoris Muscle MassHand-Held Grip Strength","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":"47 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between walking speed early after admission and all-cause death and/or re-admission in patients with acute decompensated heart failure.","authors":"Kohei Nozaki, Nobuaki Hamazaki, Kentaro Kamiya, Shota Uchida, Takumi Noda, Kensuke Ueno, Kazuki Hotta, Emi Maekawa, Atsuhiko Matsunaga, Minako Yamaoka-Tojo, Junya Ako","doi":"10.1093/eurjcn/zvad092","DOIUrl":"10.1093/eurjcn/zvad092","url":null,"abstract":"<p><strong>Aims: </strong>Patients with heart failure (HF) frequently experience decreased physical function, including walking speed. Slower walking speed is associated with poorer prognosis. However, most of these reports focused on patients with stable HF, and the relationship between walking speed in acute phase and clinical outcomes is unclear. Therefore, we aimed to investigate the associations between walking speed early after admission and clinical events in patients with acute decompensated HF (ADHF).</p><p><strong>Methods and results: </strong>We reviewed consecutive 1391 patients admitted due to ADHF. We measured walking speed the first time to walk on the ward more than 10 m after admission, and the speed within 4 days after admission was included in this study. The primary outcome was combined events (all-cause death and/or re-admission due to HF). The follow-up period was up to 1 year from the discharge. The study population had a median age of 74 years [interquartile range (IQR): 65-80 years], and 35.9% of patients were females. The median walking speed was 0.70 m/s (IQR: 0.54-0.88 m/s). Combined events occurred in 429 (30.8%) patients. Faster walking speed was independently associated with lower rate of combined events (adjusted hazard ratio per 0.1 m/s increasing: 0.951, 95% confidence interval: 0.912-0.992).</p><p><strong>Conclusion: </strong>Faster walking speed within 4 days after admission was associated with favourable clinical outcomes in patients with ADHF. The results suggest that measuring walking speed in acute phase is useful for earlier risk stratification.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"374-381"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of osteoporosis risk assessment score in patients with heart failure: comparison with the osteoporosis self-assessment tool for Asians.","authors":"Ryo Numazawa, Satoshi Katano, Toshiyuki Yano, Masayuki Koyama, Ryohei Nagaoka, Yusuke Fujisawa, Kotaro Yamano, Suguru Honma, Katsuhiko Ohori, Hidemichi Kouzu, Masaki Katayose, Masato Furuhashi, Kazufumi Tsuchihashi, Akiyoshi Hashimoto","doi":"10.1093/eurjcn/zvad089","DOIUrl":"10.1093/eurjcn/zvad089","url":null,"abstract":"<p><strong>Aims: </strong>Osteoporosis is prevalent and is associated with poor prognosis in patients with heart failure (HF). However, bone mineral density measurement by a dual-energy X-ray absorptiometry (DEXA) scan is not always available in a daily clinical setting or large-scale population-based studies.</p><p><strong>Methods and results: </strong>A single-centre, cross-sectional observational study was conducted with 387 patients [median age: 77 years (interquartile range: 68-83 years); 37% women]. Bone mineral densities were measured by DEXA scans, and osteoporosis was diagnosed as ≤-2.5 standard deviation of the bone mineral densities in healthy young adults. Osteoporosis risk assessment score (ORAS) was developed using significant predictors from a logistic regression model for osteoporosis and was subsequently validated. Osteoporosis was found in 103 (27%) of the 387 HF patients. Multivariate logistic regression analyses yielded the ORAS based on sex, body mass index, handgrip strength, and anti-coagulant therapy utilization. The C-index of ORAS in the developmental set (0.796, 95% confidence interval: 0.747-0.845) was similar to the bootstrap validation of the prediction model (0.784) and tended to be higher than that of the osteoporosis self-assessment tool for Asians (OSTA). A nomogram of ORAS, established on the basis of the final logistic regression model, demonstrated 100% sensitivity at the lowest score (35 points), with an optimal cut-off point of 127 points, yielding 85% sensitivity and 62% specificity.</p><p><strong>Conclusion: </strong>Osteoporosis risk assessment score exhibits superior predictive performance to OSTA in predicting osteoporosis in HF patients, establishing itself as a valuable tool for early detection in both daily clinical practice and large-scale population-based studies.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"408-417"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' perspective of quality-of-care and its correlation to quality-of-life following spontaneous coronary artery dissection.","authors":"Quan Dang, Barbara Murphy, Robert M Graham, Aniket Puri, Sarah Ford, Simone Marschner, James J H Chong, Sarah Zaman","doi":"10.1093/eurjcn/zvad096","DOIUrl":"10.1093/eurjcn/zvad096","url":null,"abstract":"<p><strong>Aims: </strong>Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of myocardial infarction. We aimed to investigate SCAD survivors' perceptions of their quality-of-care and its relationship to quality-of-life.</p><p><strong>Methods and results: </strong>An anonymous survey was distributed online to SCAD survivors involved in Australian SCAD support groups, with 172 (95.3% female, mean age 52.6 ± 9.2 years) participants in the study. The survey involved assessment of quality-of-life using a standardized questionnaire (EQ-5DTM-3L). Respondents rated the quality-of-care received during their hospital admission for SCAD with a median of 8/10 [interquartile range (IQR) 7-10]. Respondents ≤ 50 years vs. >50 years were more likely to perceive that their symptoms were not treated seriously as a myocardial infarction (χ2 = 4.127, df = 1, P < 0.05). Participants rated clinician's knowledge of SCAD with a median of 4/10 (IQR 2-8) and 7/10 (IQR 3-9) for Emergency and Cardiology clinicians, respectively (P < 0.05). The internet was the most selected source (45.4%) of useful SCAD information. The mean EQ-5DTM summary index was 0.79 (population norm 0.87). A total of 47.2% of respondents reported a mental health condition diagnosis, with 36% of these diagnosed after their admission with SCAD. Quality-of-life was significantly associated with perceived quality-of-care: EQ-5DTM index/(1-EQ-5DTM index) increased by 13% for each unit increase in quality-of-care after adjusting for age and comorbidities (P < 0.001).</p><p><strong>Conclusion: </strong>While SCAD survivors rated their overall hospital care highly, healthcare providers' knowledge of SCAD was perceived to be poor, and the most common source of SCAD information was the internet. Mental health conditions were common, and a significant association was observed between perceived quality-of-care and SCAD survivors' quality-of-life.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"400-407"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial artery occlusion after coronary angiography with trans radial access: a nurse led study employing duplex ultrasonography and the reverse Barbeau test.","authors":"Ulrika Johansson, Kjetil Isaksen, Ingvild Dalen, Alf Inge Larsen","doi":"10.1093/eurjcn/zvad090","DOIUrl":"10.1093/eurjcn/zvad090","url":null,"abstract":"<p><strong>Aims: </strong>Trans-radial access (TRA) is the recommended approach for coronary angiography and percutaneous coronary intervention (PCI). Radial artery occlusion (RAO) is the most common complication. We examined the incidence of RAO by means of duplex ultrasonography (DUSG) and the reverse Barbeau test (RBT), after TRA in a clinical setting using conventional pressure dressings to achieve haemostasis. All radial artery patency examinations were performed by one dedicated nurse after a brief training course, we assessed the feasibility and quality of this routine in regular clinical practice.</p><p><strong>Methods and results: </strong>In total 97 patients undergoing first-time coronary angiograph and in some cases, PCI via TRA completed the study. Conventional pressure dressing as means of haemostasis was used. Radial artery patency was examined by DUSG and by RBT, before and at follow-up 1 month after the procedure. An inter- and intra-observer validation of the ultrasound measurements was performed before inclusion. Two cases of RAO (2.1%) were discovered following TRA. All RAO cases were detected by both DUSG and the RBT. Results from the inter-observer validation showed no statistically significant discrepancy between an experienced physician and a newly trained nurse operator (P = 0.403). An intraclass correlation coefficient (ICC) was calculated at 0.89 indicating excellent reproducibility.</p><p><strong>Conclusion: </strong>In a high-volume TRA centre, we found a low incidence of RAO using conventional pressure dressing as means of haemostasis. The easy-to-use RBT detected all cases of RAO. Following a short course of training, a nurse from the cardiac catheterization laboratory was able to perform high quality DUSG examinations of the radial artery to assess patency.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"367-373"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between perception of noise from a mechanical heart valve and symptoms of anxiety and depression.","authors":"Lena N Dehli, Tone M Norekvål, Rune Haaverstad, Geir Egil Eide, Kjersti Oterhals","doi":"10.1093/eurjcn/zvad091","DOIUrl":"10.1093/eurjcn/zvad091","url":null,"abstract":"<p><strong>Aims: </strong>Patients with symptomatic aortic valve stenosis are efficiently treated by aortic valve replacement (AVR), using a biological or mechanical valve. For some patients with mechanical valves, the metallic clicking sound may be problematic. The aim of this study was to investigate the perceived disturbance from the sound of a mechanical valve and the association between noise perception and symptoms of anxiety and depression.</p><p><strong>Methods and results: </strong>The study had a cross-sectional design. In April 2013, all patients who had undergone AVR at one university hospital during the period 2000-12 were invited by post to participate. The primary variables were assessed using a valve-specific questionnaire and the Hospital Anxiety and Depression Scale. Of the 912 (77%) respondents, 245 had mechanical valves. Of these, 59 (24%) were women, the mean (standard deviation) age was 61 (11) years, and the mean time since surgery was 7 (3) years. The valve-specific questionnaire showed that 84% of the patients could sometimes or often hear the valve sound. A moderate positive correlation was found between valve prosthesis noise disturbance and anxiety, r = 0.35 (P = 0.001), and depression, r = 0.27 (P = 0.001). In a multiple linear regression analysis, valve noise perception was only significantly associated with anxiety among several other bio-psychosocial factors.</p><p><strong>Conclusion: </strong>This study shows an association between valve noise disturbance and symptoms of anxiety and highlights the importance of preparing all patients for the sound from the mechanical valves that arises after surgery.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"391-399"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on recovery from cardiac surgery over time: results of the CardiacCovid study from three UK national lockdowns.","authors":"Julie Sanders, Emma Beaumont, Matthew Dodd, Sarah E Murray, Gareth Owens, Alan Berry, Edward Hyde, Teofila Bueser, Tim Clayton, Aung Ye Oo","doi":"10.1093/eurjcn/zvad084","DOIUrl":"10.1093/eurjcn/zvad084","url":null,"abstract":"<p><p>This prospective study explores health-related quality of life (EQ-5D-5L), event-related distress (IES-R), and depression (CES-D) after cardiac surgery during three COVID-19 lockdowns imposed in the UK. Overall, 253 patients (Lockdown 1 n = 196; 2 n = 45; 3 n = 12) completed the above-mentioned questionnaires at baseline, 1 week after discharge, and 6 weeks and 6 and 12 months after surgery. While EQ-5D-5L values were similar across all cohorts, those who underwent surgery during Lockdowns 2 and 3 had higher IES-R scores at 1 year and higher IES-R and CES-D baseline scores, respectively. Generally, increased distress, worse depression, and poorer HRQoL were observed in women. Registration ClinicalTrials.gov: NCT04366167.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"418-422"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10004519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy, numeracy, graph literacy, and digital literacy: an overview of definitions, evaluation methods, and best practices.","authors":"Meghan Reading Turchioe, Sabrina Mangal","doi":"10.1093/eurjcn/zvad085","DOIUrl":"10.1093/eurjcn/zvad085","url":null,"abstract":"<p><p>Health literacy is an important skill for people receiving care. Those with limited literacy face disparities in their care and health outcomes when strategies for addressing literacy are not used when delivering health information. In this article, we introduce the importance of considering health literacy, defining it and related concepts including numeracy, graph literacy, and digital literacy, and discuss open questions about measuring health literacy in clinical care. Finally, we present best practices, including assuming 'universal precautions', carefully considering wording, leveraging visualizations, recognizing cultural differences in interpretation, providing guidance on pilot testing, and considering digital literacy when developing electronic materials.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"423-428"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10023574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient concern regarding bleeding side effects from oral anticoagulation therapy for atrial fibrillation: an analysis from the multicentre KiCS-AF registry.","authors":"Ikuko Ueda, Shun Kohsaka, Nobuhiro Ikemura, Takehiro Kimura, Yoshinori Katsumata, Ryo Takemura, Masahiro Suzuki, Seiji Takatsuki, Daisuke Koide, Keiichi Fukuda","doi":"10.1093/eurjcn/zvad094","DOIUrl":"10.1093/eurjcn/zvad094","url":null,"abstract":"<p><strong>Aims: </strong>The purpose of this study is to utilize patient-reported outcomes to determine the percentage of patients concerned about mild to moderate bleeding side effects of anticoagulants.</p><p><strong>Methods and results: </strong>We consecutively enrolled 3312 newly diagnosed or referred patients for atrial fibrillation (AF) management from 11 sites within the Keio interhospital Cardiovascular Studies-Atrial Fibrillation registry between September 2012 and May 2018. Of these patients, 2636 (79.5%) were taking oral anticoagulants at enrollment. Using the Atrial Fibrillation Effect on Quality-of-life questionnaire (AFEQT), the patients who responded '1: not at all bothered' or '2: hardly bothered' on the seven-point scale regarding bleeding side effects were classified as the 'no OAC concern' group while those responding '3: a little bothered' to '7: extremely bothered' were classified as the 'OAC concern' group. On baseline analysis, 29.3% (n = 772) were 'concerned' about bleeding side effects. The proportion of women and patients with AF-related symptoms was higher in the oral anticoagulant (OAC) concern vs. no OAC concern group (36.9% vs. 29.8%, P < 0.0004 and 66.2% vs. 56.7%, P < 0.0001, respectively). The CHADS2 scores ≥ 2 were comparable between groups. Of the 430 patients in the 1-year follow-up analysis, the proportion of the continued OAC concern group (1 year from enrollment) was 41.6%. The dabigatran, rivaroxaban, and apixaban usage rates were comparable between the two groups in baseline and 1-year follow-up analysis.</p><p><strong>Conclusion: </strong>Approximately one-third of all patients with AF on anticoagulant therapy were concerned regarding bleeding from short- and long-term anticoagulant use.</p>","PeriodicalId":50493,"journal":{"name":"European Journal of Cardiovascular Nursing","volume":" ","pages":"358-366"},"PeriodicalIF":2.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}