METHODS: From 2016 onward, patients with diagnosed AF were recruited for the observational ARENA registry. In 2018, an intervention period was initiated involving population-based information campaigns on AF diagnosis and therapies. The \"control group\" was recruited prior to initiation, and the \"intervention group\" afterward. Patients underwent standardized follow-up > 1 year after recruitment. Clinical outcomes, therapy and quality of life were compared between the two groups.
RESULTS: A total of 2769 patients were included. This real-world cohort showed high adherence to oral anticoagulation therapy (OAC) and an increased use of NOACs over vitamin K antagonists over time. In the intervention group (n = 1362), more patients continued OAC at follow-up (87.1% vs. 81.5%, P = 0.002). However, this difference was not significant in the patient subgroup with class I/IIa indications for OAC (90.1% vs. 87.5%, P = 0.11). AF-related re-hospitalization was lower in the intervention group (6.8% vs. 12.3%, P < 0.001). There was no significant difference in quality of life. AF-related anxiety was reduced at follow-up. Of note, nearly a quarter of all patients stated that ARENA had influenced their health perception.
CONCLUSIONS: Tailored community-based campaigns may raise awareness for AF-related health issues, supporting therapy adherence. Future public strategies to improve quality of life in AF patients should be investigated, as the ARENA project hints at a potential benefit of population-based campaigns.
BACKGROUND: ClinicalTrials.gov (Identifier: NCT02978248).
方法:从2016年开始,纳入诊断为AF的患者进行ARENA观察性登记.2018年,启动了一个干预期,涉及基于人群的房颤诊断和治疗信息运动。“对照组”是在启动前招募的,以及之后的“干预组”。患者在招募后>1年接受标准化随访。临床结果,比较两组患者的治疗效果和生活质量。
结果:共纳入2769例患者。这个现实世界的队列显示,随着时间的推移,口服抗凝治疗(OAC)的依从性高,NOAC的使用超过维生素K拮抗剂。在干预组(n=1362)中,更多患者在随访时继续OAC(87.1%vs.81.5%,P=0.002)。然而,在具有OACI/IIa类适应症的患者亚组中,这种差异并不显着(90.1%与87.5%,P=0.11)。干预组房颤相关再住院率较低(6.8%vs.12.3%,P<0.001)。生活质量无显著差异。随访时房颤相关焦虑降低。值得注意的是,近四分之一的患者表示ARENA影响了他们的健康认知.
结论:量身定制的社区活动可能会提高人们对房颤相关健康问题的认识,支持治疗依从性。应研究未来改善房颤患者生活质量的公共策略,ARENA项目暗示了以人口为基础的运动的潜在好处。
背景:ClinicalTrials.gov(标识符:NCT02978248)。