Assessment of comorbidity awareness in patients with atrial fibrillation: The ACAPAF study

Abstract

Background and aim: Systematic and integrated comorbidity management in patients with atrial fibrillation (AF) requires patient involvement, starting with comorbidity awareness. This study evaluates comorbidity awareness in patients with AF before and after a first nurse-led AF clinic visit and after six months. We also measured the time needed for full comorbidity mapping using the EHRA-PATHS software. Methods: This prospective two-centre study included patients diagnosed with AF attending the AF clinic for the first time. The software systematically assessed 23 comorbidities. Patients completed a comorbidity awareness questionnaire, focusing on nine AF-related comorbidities two weeks before their first visit, less than a week after, and six months later. Patients also had a telephone consultation with the AF nurse to discuss their comorbidities 1-3 months post-visit. Results: The study included 76 patients (mean age 68.3 +/- 10.3 y). Baseline awareness of comorbidity relevance for AF ranged between 11.1-100.0 %. Awareness about own alcohol consumption was the most 'underestimated' comorbidity before first contact (50.0 %), while smoking was most 'overestimated' (55.6 %; i.e. admitted in private but not during formal evaluation by nurses). The impact of an AF clinic visit on awareness of personal comorbidities was limited (p = 0.456), and also after an additional phone consultation, awareness was suboptimal after six months (p = 0.099). AF nurses needed 18.4 +/- 8.7 min to complete the software. Conclusions: Patients' comorbidity awareness is moderate, and more educational efforts are needed to improve their awareness. A systematic and complete comorbidity evaluation at the AF clinic using EHRA-PATHS software can be done within a reasonable time frame.