The Effect of Nurse Practitioner-Led Care on Health-Related Quality of Life in Adult Patients with Atrial...

Atrial fibrillation (AF) is associated with significant morbidity, mortality, and healthcare resource utilization. Health system limitations can result in delays to specialty cardiovascular (CV) care. Nurse practitioner (NP)-led care may improve access and quality of care. The purpose of this study was to assess the effect of NP-led care compared to usual cardiologist care on quality of life in patients with AF.

Patients with AF referred to a specialized cardiac clinic were randomized to NP-led or usual cardiologist care for 6 months. Primary outcome was the difference in change in atrial fibrillation effect on quality of life (AFEQT) scores at 6 months between groups. Secondary outcomes were difference in change of EuroQOL EQ-5D-3L scores at 6 months between groups, composite outcome of death from CV causes, hospitalizations, emergency department visits, and patient satisfaction measured by the Consultant Satisfaction Questionnaire (CSQ) at 6 months.

We enrolled 150 subjects, with 10% loss to follow-up. Study subjects were 62% male, with a mean age of 64 years, and an overall AFEQT baseline score of 66.45 ±4:86. No significant baseline differences between groups were present. AFEQT scores, EQ-5D-3L, and CV outcomes were not different at 6 months; NP-led care showed higher patient satisfaction in the CSQ domain of professional care (76.32 ± 11.32 vs 65.75 ± 15.45, P = 0.0006).

We found no difference in quality of life or CV outcomes at 6 months with NP-led care vs usual cardiologist care. NP-led care resulted in higher levels of patient satisfaction. Further research is needed to explore the effect of NP-led AF care in CV settings.

NCT02745236.