Author + information
- Received August 5, 2019
- Revision received August 19, 2019
- Accepted August 19, 2019
- Published online October 21, 2019.
- Celine Gallagher, PhDa,b,
- Debra Rowett, B Pharmc,d,
- Karin Nyfort-Hansen, B Pharm, Grad Dip Ed(Health)a,
- Shalini Simmons, RNd,
- Anthony G. Brooks, PhDa,
- John R. Moss, BEc, MSocSci, MBBSe,
- Melissa E. Middeldorp, PhDa,b,
- Jeroen M. Hendriks, PhDa,b,
- Tina Jones, PhDf,
- Rajiv Mahajan, MD, PhDa,g,
- Dennis H. Lau, MBBS, PhDa,b and
- Prashanthan Sanders, MBBS, PhDa,b,∗ ()
- aCentre for Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia
- bDepartment of Cardiology, Royal Adelaide Hospital, Adelaide, Australia
- cSchool of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
- dDrug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, Australia
- eSchool of Public Health, The University of Adelaide, Adelaide, Australia
- fCentral Adelaide Local Health Network, Adelaide, Australia
- gDepartment of Cardiology, Lyell McEwin Health Service, Adelaide, Australia
- ↵∗Address for correspondence:
Dr. Prashanthan Sanders, Centre for Heart Rhythm Disorders, Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide, South Australia 5000, Australia.
• The prevalence of AF has grown exponentially in recent decades and is associated with high hospitalization burden and poor quality of life.
• Education has been advocated as a key component of chronic condition management, yet the role of education on outcomes in the AF population is poorly defined.
• Structured educational visiting, based on the principles of academic detailing, has been associated with improvements in physician prescribing practices with variable effects observed in influencing patient and caregiver outcomes.
• In the HELP-AF study, an educational resource was developed and used to support delivery of education by trained clinicians, using a patient-centered structured educational visiting approach, within the patient’s home.
Education has long been recognized as an important component of chronic condition management. Whereas education has been evaluated in atrial fibrillation (AF) populations as part of multifaceted interventions, it has never been tested as a single entity. The aim of this review is to describe the rationale for and role of education as part of comprehensive AF management. The development and use of educational material as part of the intervention of a randomized controlled trial, the HELP-AF (Home-Based Education and Learning Program in AF) study, will be described. This study was designed to determine the impact of a home-based structured educational program on outcomes in individuals with AF. An educational resource was developed to facilitate delivery of 4 key messages targeted at empowering individuals to self-manage their condition. The key messages focused on strategies for managing future AF episodes, the role of pharmacotherapy in the treatment of AF, the appropriate use of medicines to manage stroke risk and the role of cardiovascular risk factor management in AF. To support structured educational visiting, an educational booklet titled Living Well With Atrial Fibrillation (AF) was developed by a multidisciplinary team and was further refined following input from expert clinicians and patient interviews. Using a structured educational visiting approach, education was delivered by trained clinicians within the patient’s home.
This study was supported by a South Australian Cardiovascular Research Network Grant jointly funded by the National Heart Foundation and the Government of South Australia. The sponsor of the study is the University of Adelaide. Several of the authors are employees of the University of Adelaide. The sponsor has had no direct involvement in the design and conduct of the study, collection, management, analysis and interpretation of the data, preparation, review or approval of the manuscript; or the decision to submit the manuscript for publication. Dr. Gallagher is supported by fellowships from the University of Adelaide. Dr. Brooks has received honoraria from MicroPort; and accepted a continuing position at MicroPort CRM (formerly LivaNova Australia Pty Limited) subsequent to the design and commencement of the study. Dr. Middeldorp is supported by fellowships from the University of Adelaide. Dr. Hendriks has received lecture and/or consulting fees paid to his institution from Medtronic and Pfizer/BMS; and is supported by the Future Leader Fellowship from the National Heart Foundation. Dr. Mahajan has received lecture and/or consulting fees paid to his institution from Medtronic, Abbott, Pfizer, and Bayer; has served on the Advisory Board of Abbott; has received research funding paid to his institution from Medtronic, Abbott, and Bayer; and is supported by a fellowship from the National Health and Medical Research Council of Australia. Dr. Lau has received lecture and/or consulting fees paid to his institution from Abbott, Boehringer Ingelheim, Biotronik, Medtronic, and Pfizer; and is supported by the Robert J. Craig Lectureship from the University of Adelaide and a mid-career fellowship from the Hospital Research Foundation. Dr. Sanders has served on the Advisory Boards of Medtronic, Boston Scientific, Abbott Medical, Pacemate, and CathRx; has received research and/or lecture fees paid to his institution from Boston Scientific, Medtronic, Abbott Medical, and MicroPort; and has received a practitioner fellowship from the National Health and Medical Research Council and National Heart Foundation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received August 5, 2019.
- Revision received August 19, 2019.
- Accepted August 19, 2019.
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