Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/110090
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Integrated care in atrial fibrillation: a systematic review and meta-analysis
Author: Gallagher, C.
Elliott, A.
Wong, C.
Rangnekar, G.
Middeldorp, M.
Mahajan, R.
Lau, D.
Sanders, P.
Hendriks, J.
Citation: Heart, 2017; 103(24):1947-1953
Publisher: BMJ Publishing Group
Issue Date: 2017
ISSN: 1355-6037
1468-201X
Statement of
Responsibility: 
Celine Gallagher, Adrian D Elliott, Christopher X Wong, Geetanjali Rangnekar, Melissa E Middeldorp, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders, Jeroen M L Hendriks
Abstract: Objective: Atrial fibrillation (AF) is an emerging global epidemic associated with significant morbidity and mortality. Whilst other chronic cardiovascular conditions have demonstrated enhanced patient outcomes from coordinated systems of care, the use of this approach in AF is a comparatively new concept. Recent evidence has suggested that the integrated care approach may be of benefit in the AF population, yet has not been widely implemented in routine clinical practice. We sought to undertake a systematic review and meta-analysis to evaluate the impact of integrated care approaches to care delivery in the AF population on outcomes including mortality, hospitalisations, emergency department visits, cerebrovascular events and patient-reported outcomes. Methods: PubMed, Embase and CINAHL databases were searched until February 2016 to identify papers addressing the impact of integrated care in the AF population. Three studies, with a total study population of 1383, were identified that compared integrated care approaches with usual care in AF populations. Results: Use of this approach was associated with a reduction in all-cause mortality (OR 0.51, 95% CI 0.32 to 0.80, p=0.003) and cardiovascular hospitalisations (OR 0.58, 95% CI 0.44 to 0.77, p=0.0002) but did not significantly impact on AF-related hospitalisations (OR 0.82, 95% CI 0.56 to 1.19, p=0.29) or cerebrovascular events (OR 1.00, 95% CI 0.48 to 2.09, p=1.00). Conclusions: The use of the integrated care approach in AF is associated with reduced cardiovascular hospitalisations and all-cause mortality. Further research is needed to identify optimal settings, methods and components of delivering integrated care to the burgeoning AF population.
Keywords: atrial fibrillation
Description: Published Online First 10 May 2017
Rights: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
RMID: 0030069730
DOI: 10.1136/heartjnl-2016-310952
Appears in Collections:Medicine publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.