Factors Associated with Adherence to the Atrial Fibrillation Better Care (ABC) Pathway Among Rural Patients with...

The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with AF is extremely low.

To explore the factors and mechanisms of adherence to the ABC pathway based on the integrated theory of health behavior change (ITHBC) among rural patients with AF.

In this cross-sectional study, we recruited 940 patients with AF from rural areas in China from July 2022 to September 2023. Patients completed a questionnaire covering AF-related demographic and clinical characteristics, AF knowledge, AF health beliefs, AF self-management ability, and social support. Adherence to ABC pathway was assessed based on AF-demographic and clinical characteristics. Path analysis was used to explore the relationship between variables.

Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability (β = 0.449; P<0.001) and social support (β = 0.429; P<0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge (β = 0.211; P<0.001), AF health beliefs (β = 0.350; P<0.001) and social support (β = 0.085; P<0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge (β = 0.121; P<0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability.

AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.