Helping healthcare professionals manage atrial fibrillation
A recent seminar published in ‘The Lancet’ presents research that has been supported by EU funding through the CATCH ME project. It sets out a stark truth: 1-3 % of health care budgets are taken up by costs relating to stroke, heart failure, sudden death, emergency hospital admissions, and other complications. Many patients are only diagnosed with the condition when admitted to hospital for acute cardiac decompensation or stroke. Once diagnosed, AF requires multidimensional management covering rate and rhythm control along with the treatment of underlying and concomitant conditions, and acute management. Providing this consistently to all affected patients is tricky despite better knowledge of treatment options and improvements in the organisation of patient care. The impact of these complications will worsen over time as the population ages and becomes increasingly affected. Less than one in 200 people younger than 50 years, but more than one in ten people in populations aged 80 years or older, have atrial fibrillation. Practical assistance to healthcare professionals The CATCH ME (Characterising Atrial Fibrillation by Translating its Causes into Health Modifiers in the Elderly) project is trying to reduce the complexities surrounding the need for multidimensional management. It has recently launched a mobile platform that contains two applications for healthcare professionals and patients to improve clinical management and quality of care. A first version of these tools has been integrated in the ESC AF Clinical Guidelines App, available for both Apple and Android operating systems. In their seminar ‘The future of atrial fibrillation management: integrated care and stratified therapy’ published in April, researchers explain, ‘Integrated atrial fibrillation care requires good communication between all stake holders; such communication will benefit from a common information technology infrastructure, (eg, tools used by patients and health-care professionals). The European Society of Cardiology, supported by the CATCH ME consortium, provides two exemplary information technology tools supporting integrated atrial fibrillation care for smartphones’. How does the app work? The app sets out the European Society of Cardiology’s Pocket Guidelines for 24 areas including Cardiac Pacing and Cardiac Resynchronisation Therapy (Pacing) and Ventricular Arrhythmias and Sudden Cardiac Death (VA+SCD). It puts two clinical, interactive tools at the fingertips of healthcare professionals: Pathways of care and risk scores calculators, such as the CHA2DS2-VASc, and a novel Overall Treatment Manager created by CATCH ME to provide a treatment package, or pathway, based on the clinical conditions or individual patient data. The new CATCH ME tools based on the ESC Clinical Practice Guidelines on Afib and fully integrated with a healthcare professional’s current Afib tools, will, says the ESC, revolutionise everyday clinical decision-making and patient follow-up. Swift decision-making can make the difference between life and death and tools such as an always-to-hand, clearly set out app can support clinicians in line with best practice guidelines. CATCH ME intends to personalise prevention and management of Afib patients and implement best clinical practice when the doctors and nurses concerned are under pressure to make a rapid decision. The way forward in tackling this high-impact condition Ongoing clinical research efforts will aim to establish when to initiate oral anticoagulation in patients with device-detected atrial high-rate episodes. Focus is also on quantifying the prognostic effect of early and comprehensive rhythm control therapy, including atrial fibrillation ablation. Researchers are also interested in delineating optimum methods to reduce bleeding complications in patients treated with anticoagulation. For more information, please see: project website
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