Improving the Management of Atrial Fibrillation in General Practice: Protocol for a Mixed Methods Study.
atrial fibrillation
cross-sectional studies
general practice
medical record systems, computerized
qualitative research
Journal
JMIR research protocols
ISSN: 1929-0748
Titre abrégé: JMIR Res Protoc
Pays: Canada
ID NLM: 101599504
Informations de publication
Date de publication:
09 Nov 2020
09 Nov 2020
Historique:
received:
10
06
2020
accepted:
25
08
2020
revised:
18
08
2020
entrez:
9
11
2020
pubmed:
10
11
2020
medline:
10
11
2020
Statut:
epublish
Résumé
Atrial fibrillation (AF) is one of the commonest arrhythmias observed in general practice. The thromboembolic complications of AF include transient ischemic attack, stroke, and pulmonary embolism. Early recognition of AF can lead to early intervention with managing the risks of these complications. The primary aim of this study is to investigate if patients are managed in general practice according to current national guidelines. In addition, the study will evaluate the impact of direct oral anticoagulant use with respect to AF complications in a real-world dataset. The secondary aims of the study are to develop a dashboard that will allow monitoring the management of AF in general practice and evaluate the usability of the dashboard. The study was conducted in 2 phases. The initial phase was a quantitative analysis of routinely collected primary care data from the Oxford Royal College of General Practitioners Research and Surveillance Center (RCGP RSC) sentinel network database. AF cases from 2009 to 2019 were identified. The study investigated the impact of the use of anticoagulants on complications of AF over this time period. We used this dataset to examine how AF was managed in primary care during the last decade. The second phase involved development of an online dashboard for monitoring management of AF in general practice. We conducted a usability evaluation for the dashboard to identify usability issues and performed enhancements to improve usability. We received funding for both phases in January 2019 and received approval from the RCGP RSC research committee in March 2019. We completed data extraction for phase 1 in May 2019 and completed analysis in December 2019. We completed building the AF dashboard in May 2019. We started recruiting participants for phase 1 in May 2019 and concluded data collection in July 2019. We completed data analysis for phase 2 in October 2019. The results are expected to be published in the second half of 2020. As of October 2020, the publications reporting the results are under review. Results of this study will provide an insight into the current trends in management of AF using real-world data from the Oxford RCGP RSC database. We anticipate that the outcomes of this study will be used to guide the development and implementation of an audit-based intervention tool to assist practitioners in identifying and managing AF in primary care. RR1-10.2196/21259.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation (AF) is one of the commonest arrhythmias observed in general practice. The thromboembolic complications of AF include transient ischemic attack, stroke, and pulmonary embolism. Early recognition of AF can lead to early intervention with managing the risks of these complications.
OBJECTIVE
OBJECTIVE
The primary aim of this study is to investigate if patients are managed in general practice according to current national guidelines. In addition, the study will evaluate the impact of direct oral anticoagulant use with respect to AF complications in a real-world dataset. The secondary aims of the study are to develop a dashboard that will allow monitoring the management of AF in general practice and evaluate the usability of the dashboard.
METHODS
METHODS
The study was conducted in 2 phases. The initial phase was a quantitative analysis of routinely collected primary care data from the Oxford Royal College of General Practitioners Research and Surveillance Center (RCGP RSC) sentinel network database. AF cases from 2009 to 2019 were identified. The study investigated the impact of the use of anticoagulants on complications of AF over this time period. We used this dataset to examine how AF was managed in primary care during the last decade. The second phase involved development of an online dashboard for monitoring management of AF in general practice. We conducted a usability evaluation for the dashboard to identify usability issues and performed enhancements to improve usability.
RESULTS
RESULTS
We received funding for both phases in January 2019 and received approval from the RCGP RSC research committee in March 2019. We completed data extraction for phase 1 in May 2019 and completed analysis in December 2019. We completed building the AF dashboard in May 2019. We started recruiting participants for phase 1 in May 2019 and concluded data collection in July 2019. We completed data analysis for phase 2 in October 2019. The results are expected to be published in the second half of 2020. As of October 2020, the publications reporting the results are under review.
CONCLUSIONS
CONCLUSIONS
Results of this study will provide an insight into the current trends in management of AF using real-world data from the Oxford RCGP RSC database. We anticipate that the outcomes of this study will be used to guide the development and implementation of an audit-based intervention tool to assist practitioners in identifying and managing AF in primary care.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
UNASSIGNED
RR1-10.2196/21259.
Identifiants
pubmed: 33164903
pii: v9i11e21259
doi: 10.2196/21259
pmc: PMC7683254
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e21259Informations de copyright
©Simon de Lusignan, F D Richard Hobbs, Harshana Liyanage, Filipa Ferreira, Manasa Tripathy, Neil Munro, Michael Feher, Mark Joy. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 09.11.2020.
Références
Eur Heart J. 2012 Jun;33(12):1500-10
pubmed: 22246443
Nat Rev Cardiol. 2011 Dec 20;9(2):71-3
pubmed: 22182957
BMJ Open. 2015 May 03;5(4):e008149
pubmed: 25941191
Circulation. 2013 Jan 1;127(1):e6-e245
pubmed: 23239837
PLoS One. 2015 May 12;10(5):e0125620
pubmed: 25965407
Am J Cardiol. 2017 Nov 15;120(10):1813-1819
pubmed: 28864318
Heart. 2017 Feb;103(3):210-218
pubmed: 27580623
Biostatistics. 2016 Oct;17(4):708-21
pubmed: 27118123
Heart. 2019 Jan;105(1):27-33
pubmed: 29991504
Fam Pract. 2006 Apr;23(2):253-63
pubmed: 16368704
J Am Med Inform Assoc. 2013 Jun;20(e1):e67-75
pubmed: 23242763
Lancet. 2014 Mar 15;383(9921):955-62
pubmed: 24315724
J Epidemiol Community Health. 2010 Oct;64(10):927-34
pubmed: 20820055
BMJ Open. 2014 Jan 27;4(1):e003839
pubmed: 24468720
Clin Cardiol. 2015 Sep;38(9):555-61
pubmed: 26418409
Circulation. 2014 Feb 25;129(8):837-47
pubmed: 24345399
J Biomed Inform. 2015 Jun;55:1-10
pubmed: 25733166
Inform Prim Care. 2006;14(3):203-9
pubmed: 17288707