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Published on: February 26, 2013
Patients' experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European
Geraldine Lee1, Edward Baker2, Hein Heidbuchel3,4
1Nursing & Midwifery, University College Cork, Cork, Ireland glee@ucc.ie.
Insights
Patients with atrial fibrillation (AF) and multiple health conditions desire more integrated care and education on managing their conditions. They value person-centered approaches but face challenges with fragmented healthcare systems and medication information.
Area of Science:
- Qualitative Health Research
- Patient Experience and Perception
- Cardiovascular Disease Management
Background:
- Atrial fibrillation (AF) is a common arrhythmia often co-occurring with multiple comorbidities.
- Effective management of multimorbid AF requires understanding patient perspectives on care.
- Current care models may not adequately address the complexities of living with AF and other conditions.
Purpose of the Study:
- To explore patient perceptions regarding the management of atrial fibrillation (AF) and its associated comorbidities.
- To identify patient needs and challenges in navigating healthcare for multimorbid AF.
- To understand patient experiences with treatment, lifestyle adjustments, and healthcare provider relationships.
Main Methods:
- A descriptive qualitative study utilizing in-depth individual interviews.
- Braun and Clarke's Reflexive Thematic Analysis was employed for data interpretation.
- Interviews were conducted with 30 adults (≥65 years) diagnosed with AF and at least two comorbidities across five European countries.
Main Results:
- Key themes included navigating diagnosis, adapting to life with AF, normalizing symptoms and treatment burden, and building therapeutic relationships.
- Patients desired more information on medications (especially anticoagulants) and practical advice for lifestyle changes.
- While satisfied with individual care teams, patients reported frustration with fragmented healthcare systems and a lack of integrated care.
Conclusions:
- In-depth interviews effectively captured patient experiences with multimorbid AF.
- A significant need exists for a more integrated approach to managing patients with AF and multiple comorbidities.
- Patient-centered care and improved communication are crucial for enhancing the management of complex cardiovascular conditions.
Objective:
The objective is to explore patients' perceptions on the management of atrial fibrillation (AF) and associated comorbidities.
Design:
A descriptive qualitative study involving in-depth individual interviews, analysed using Braun and Clarke's approach to Reflexive Thematic Analysis.
Setting:
Cardiology departments in teaching hospitals in five geographically diverse European countries-Belgium, Greece, Poland, Spain and the Netherlands.
Participants:
30 adults aged 65 years or older, diagnosed with AF, with two or more confirmed comorbidities were interviewed.
Results:
The average age was 73 years, 37% were women and the most common comorbidity was hypertension (n=26, 87%), followed by hypercholesterolaemia (n=12, 40%), obesity (n=10, 33%), hypothyroidism (n=9, 30%) and diabetes (n=7, 23%). Three main themes were identified: (1) navigating the diagnosis path and adapting to life with AF, (2) normalising symptoms and treatment burden and (3) striving to build a therapeutic relationship.Respondents had some knowledge about the relationship between comorbidities and AF but lacked understanding of how these comorbidities related to AF. Participants raised concerns regarding their medications, especially anticoagulants, with a desire to be given more information about them. Participants were motivated to make lifestyle adjustments but reported a lack of education and advice on how to implement and maintain these lifestyle changes. Overall, participants were very satisfied with their cardiology/AF teams, and they emphasised the importance of a person-centred approach. There was a perceived disjointedness to healthcare systems, with some reporting multiple appointments at different locations, leading to participants being frustrated and highlighting the lack of integrated care.
Conclusions:
In-depth interviews provided an excellent platform to explore the perceptions and experiences of patients living with AF and associated comorbidities and highlighted the lack of an integrated approach to multimorbid AF management.
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