scholarly journals Assessing the impact of education in atrial fibrillation: A systematic review

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
A Cano Valls ◽  
JM Hendriks ◽  
P Sanders ◽  
LL Mont ◽  
C Gallagher
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Heart Rhythm ◽  
Educational Interventions ◽  
Eligibility Criteria ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial Fibrillation (AF) is the most common heart rhythm disorder. Patient education is recommended as part of comprehensive AF management. Despite this the impact of education alone on outcomes in AF populations is unknown. Purpose The aim of this study was to describe the impact of education on clinically relevant outcomes in patient with AF including mortality, hospital admissions, emergency department presentations, stroke and quality of life.  Methods The authors searched Pubmed, Embase, CINAHL, Cochrane database and Psycinfo from inception until September 2019. Studies were included if they were prospective and of randomized controlled or observational design with a minimum follow-up 3 months and published in English. Results A total of 1667 studies were screened with 37 undergoing full text review and 6 meeting eligibility criteria. There was a total of 588 participants with a mean age of 65.63 ± 11.05 and 60.71% were male. A meta-analysis was unable to be performed due to heterogeneity in reporting of outcomes. Two studies examined the impact of education on mortality with no impact evident from either intervention. The impact of education on hospitalisations (all cause – 3 studies, cardiovascular – 1 study and AF - 2 studies) was explored in five studies with no impact on this outcome from any intervention. Similarly, there was no impact of education on emergency department presentations, except for one study in which a video was used in addition to standardised education. There was no impact on stroke from two studies exploring this outcome. There was no evidence of impact of education on general or AF specific quality of life. Conclusions There is little evidence to suggest that educational interventions to date have significantly impacted on death, hospitalisations, emergency department presentations or quality of life in AF populations. There is an urgent need to identify optimal modes and components of educational interventions to improve patient outcomes and reduce health care burden in AF.

scholarly journals P101: Quality of life in patients discharged from the emergency department with atrial fibrillation or flutter (AF/AFL): a prospective cohort study

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S112
Author(s):  
S. Patrick ◽  
P. Duke ◽  
K. Lobay ◽  
M. Haager ◽  
B. Deane ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Emergency Department ◽  
Short Form ◽  
Bodily Pain ◽  
Emergency Physicians ◽  
Health Related Qol ◽  
Health Related ◽  
The Impact

Introduction: Following an emergency department (ED) presentation for acute atrial fibrillation and/or flutter (AF/AFL), patients often experience anxiety, depression and impaired health-related quality of life (QoL). Emergency physicians may prescribe appropriate thrombo-embolic (TE) prophylaxis upon discharge; however, the QoL of these patients is unclear. This study measured the QoL of patients with AF/AFL following discharge to determine the factors associated with QoL. Methods: Patients ≥18 years of age identified by the attending physician as having a diagnosis of acute AF/AFL confirmed by ECG were prospectively enrolled from three Edmonton, AB EDs. Using standardized enrollment forms, trained research assistants collected data on patient demographics factors and management both in the ED and at discharge. Patients’ health-related QoL was assessed up to 20 days after their initial ED visit by a telephone interview based on six domains of the short-form 8 health survey. Results: From a total of 196 enrolled patients, 121 (62%) were male and the mean age was 63 years (standard deviation ±14). Most patients had previous history of AF/AFL (71%), and emergency physicians had the opportunity to treat or revise TE prevention therapy in 19% of the patients. The majority (89%) were discharged with prescriptions for antiplatelet or anticoagulant agents, and 188 (96%) were contacted by telephone at a median of 7 days. Most patients rated their overall health between good and excellent (70%); however, 30% assessed their health as fair or very poor. Many also reported having physical limitations (54%), difficulties completing their daily work (42%), bodily pain (32%) and limitations in social activities (32%). Finally, some patients reported having low energy (25%). At follow up, patients receiving adequate TE prevention rated their health to be similar to those without adequate TE prevention (30% vs 23%; p=0.534). Conclusion: Overall, patients with acute, symptomatic AF/AFL seen in the ED have impairments in health-related QoL following discharge from the ED. Many factors contribute to this impairment; however, providing patients with appropriate TE prophylaxis at discharge did not explain these findings. Further research is required to explore the impact of AF/AFL on patient’s health-related QoL after discharge from the ED.

scholarly journals The impact of the acceptance of illness on the quality of life of patients with atrial fibrillation

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
B Jankowska-Polanska ◽  
D Kasperczak ◽  
N Swiatoniowska-Lonc ◽  
J Polanski
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Heart Rhythm ◽  
Well Being ◽  
Supraventricular Arrhythmia ◽  
Heart Rhythm Disorders ◽  
The Mean ◽  
Acceptance Of Illness ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. AF and the complications associated with it interfere with the physical, mental and social well-being of a person, thus affecting the quality of life. An important factor affecting the quality of life of patients with AF is the acceptance of illness (AI). In spite of the large problem related to this subject, the analysis of the relation between the acceptance of illness and the quality of life of patients with AF is insufficient. The aim of the study was to assess the impact of the acceptance of illness on the quality of life of patients with AF. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess the acceptance of illness and Arrhythmia-Specific questionnaire In Tachycardia and Arrhythmia (ASTA) to assess quality of life. Results. The majority of patients were secondary educated (64.27%), lived in a city (78.58%), were inactive (57.15%), were hospitalized 3-5 times (42.85%), had a cardiostimulator (23.80%) or underwent ablation (22.62%) during the last year. The average result of the acceptance of illness was 27.67 ± 7.70. 48.8% of patients had a high level of the acceptance of illness, 38.09% average, and 13.11% did not accept their illness. The mean result of quality of life for the whole studied group was (ASTA III) 25.64 ± 8.64. As regards the severity of symptoms (ASTA II) the mean result was 17.15 ± 5.89. Correlation analysis showed that the higher the level of the acceptance of illness the higher the quality of life (r = 0.640; p = 0.002) and lower the severity of AF symptoms (r=-0.51, p < 0.001). Conclusions. Patients with AF present a moderate level of disease acceptance and quality of life. The acceptance of illnessis the independent predictor and significantly increases quality of life of patients with AF.

scholarly journals Polypharmacy and health outcomes in atrial fibrillation: a systematic review and meta-analysis

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001257 ◽  
Author(s):  
Celine Gallagher ◽  
Karin Nyfort-Hansen ◽  
Debra Rowett ◽  
Christopher X Wong ◽  
Melissa E Middeldorp ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Systematic Review ◽  
Health Outcomes ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Total Study Population ◽  
The Impact

ObjectiveTo undertake a systematic review and meta-analysis examining the impact of polypharmacy on health outcomes in atrial fibrillation (AF).Data sourcesPubMed and Embase databases were searched from inception until 31 July 2019. Studies including post hoc analyses of prospective randomised controlled trials or observational design that examined the impact of polypharmacy on clinically significant outcomes in AF including mortality, hospitalisations, stroke, bleeding, falls and quality of life were eligible for inclusion.ResultsA total of six studies were identified from the systematic review, with three studies reporting on common outcomes and used for a meta-analysis. The total study population from the three studies was 33 602 and 37.2% were female. Moderate and severe polypharmacy, defined as 5–9 medicines and >9 medicines, was observed in 42.7% and 20.7% of patients respectively, and was associated with a significant increase in all-cause mortality (Hazard ratio [HR] 1.36, 95% CI 1.20 to 1.54, p<0.001; HR 1.84, 95% CI 1.40 to 2.41, p<0.001, respectively), major bleeding (HR 1.32, 95% CI 1.14 to 1.52, p<0.001; HR 1.68, 95% CI 1.35 to 2.09, p<0.001, respectively) and clinically relevant non-major bleeding (HR 1.12, 95% CI 1.03 to 1.22, p<0.01; HR 1.48, 95% CI 1.33 to 1.64, p<0.01, respectively). There was no statistically significant association between polypharmacy and stroke or systemic embolism or intracranial bleeding. Among other examined outcomes, polypharmacy was associated with cardiovascular death, hospitalisation, reduced quality of life and poorer physical function.ConclusionsPolypharmacy is highly prevalent in the AF population and is associated with numerous adverse outcomes.PROSPERO registration numberCRD42018105298.

scholarly journals Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominic O’Connor ◽  
Malcolm Brown ◽  
Martin Eatock ◽  
Richard C. Turkington ◽  
Gillian Prue
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Pancreatic Cancer ◽  
Adjuvant Therapy ◽  
Physical Function ◽  
Meta Analysis ◽  
Ductal Adenocarcinoma ◽  
Key Stakeholders ◽  
The Impact

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

The impact on quality of life in patients with burning mouth syndrome: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Juliana Vianna Pereira ◽  
Ana Gabriela Costa Normando ◽  
Carla Isabelly Rodrigues-Fernandes ◽  
César Rivera ◽  
Alan Roger Santos-Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Burning Mouth Syndrome ◽  
Burning Mouth ◽  
The Impact

Abstract 147: Impact of Risk Factor Modification in Improving Quality of Life and Arrhythmia Symptoms in Patients With Atrial Fibrillation

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Amaryah Yaeger ◽  
Nancy R Cash ◽  
Tara Parham ◽  
Rajeev Pathak ◽  
David S Frankel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Improve Quality ◽  
Risk Factor Modification ◽  
Obstructive Sleep ◽  
Sf 36 ◽  
The Impact ◽  
Factor Modification

Objective: The desired goal of atrial fibrillation (AF) management is maintenance of sinus rhythm in order to improve quality of life (QoL) and arrhythmia symptoms (AS). Although obesity and obstructive sleep apnea (OSA) are known risk factors for development of AF, these remain inadequately treated. We report the impact of prospectively modifying these risk factors on QoL and AS in AF patients (pts). Methods: AF pts with obesity (body mass index (BMI) ≥30kg/m 2 ) and/or the need for OSA management (high-risk as per Berlin Questionnaire or untreated OSA) were voluntarily enrolled in a nurse-led risk factor modification (RFM) program at their arrhythmia clinic visit. RFM entailed patient education, lifestyle modification counseling, coordination of care with appropriate specialists, and longitudinal care management. Progress with weight loss (WL) and OSA treatment was monitored via monthly follow-up calls and/or downloads from continuous positive airway pressure (CPAP) units for up to 12 months. QoL and AS were determined with the SF-36 and AF Severity Scale (AFSS) respectively, and were assessed at baseline, 6 months, and 12 months. Student t-test and chi-square tests were used to compare continuous and dichotomous variables. Results: From 11/1/16 to 10/31/17, 252 pts (age 63±11 years; male=179; paroxysmal AF=126) were enrolled as follows: 189 for obesity and 93 for OSA. The mean WL was 2.7±3.8% from baseline and 78% (n=126 of 162 pts with available data) of enrolled obese patients achieved WL. Among 93 pts at risk for OSA, 70 completed sleep studies and 50 were identified with OSA. Majority of these patients (76%; n=38 of 50) started CPAP therapy and have remained full (57%; n=17 of 30 pts with available CPAP data) and partial (13%; n=4 of 30) users. Table shows that SF-36 and AFSS scores improved for most measures of QoL and AS from baseline to 6 months. Conclusion: Participation in a risk factor modification program targeting obesity and obstructive sleep apnea can improve quality of life and arrhythmia symptoms in patients with atrial fibrillation. The impact of this strategy on long-term maintenance of sinus rhythm remains to be determined.

The impact of prurigo nodularis on quality of life: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Sherief R. Janmohamed ◽  
Eran C. Gwillim ◽  
Muhammad Yousaf ◽  
Kevin R. Patel ◽  
Jonathan I. Silverberg
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Meta Analysis ◽  
Prurigo Nodularis ◽  
The Impact
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