Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey



Koziel, Monika, Simovic, Stefan, Pavlovic, Nikola, Kocijancic, Aleksander, Paparisto, Vilma, Music, Ljilja, Trendafilova, Elina, Dan, Anca R, Kusljugic, Zumreta, Dan, Gheorghe-Andrei
et al (show 2 more authors) (2020) Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey. POLISH ARCHIVES OF INTERNAL MEDICINE-POLSKIE ARCHIWUM MEDYCYNY WEWNETRZNEJ, 130 (3). pp. 187-195.

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Abstract

<h4>Introduction</h4>The Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management.<h4>Objectives</h4>To evaluate adherence to the ABC pathway and to determine major gaps in adherence in patients in the BALKAN‑AF survey.<h4>Patients and methods</h4>In this ancillary analysis, patients from the BALKAN‑AF survey were divided into the following groups: A (avoid stroke) + B (better symptom control) + C (cardiovascular and comorbidity risk management)-adherent and -nonadherent management.<h4>Results</h4>Among 2712 enrolled patients, 1013 (43.8%) patients with mean (SD) age of 68.8 (10.2) years and mean CHA2DS2‑VASc score of 3.4 (1.8) had A+B+C-adherent management and 1299 (56.2%) had A+B+C-nonadherent management. Independent predictors of increased A+B+C-adherent management were: capital city (odds ratio [OR], 1.23; 95% CI, 1.03-1.46; P = 0.02), treatment by cardiologist (OR, 1.34; 95% CI, 1.08-1.66; P = 0.01), hypertension (OR, 2.2; 95% CI, 1.74-2.77; P <0.001), diabetes mellitus (OR, 1.28; 95% CI, 1.05-1.57; P = 0.01), and multimorbidity (the presence of 2 or more long‑ term conditions) (OR, 1.85; 95% CI, 1.43-2.38; P <0.001). Independent predictors of decreased A+B+C-adherent management were: age 80 years or older (OR, 0.61; 95% CI, 0.48-0.76; P <0.001) and history of bleeding (OR, 0.5; 95% CI, 0.33-0.75; P = 0.001).<h4>Conclusions</h4>Physicians' adherence to integrated AF management based on the ABC pathway was suboptimal. Addressing the identified clinical and system‑related factors associated with A+B+C-nonadherent management using targeted approaches is needed to optimize treatment of patients with AF in the Balkan region.

Item Type: Article
Uncontrolled Keywords: atrial fibrillation, BALKAN-AF survey, oral anticoagulants, rate control, rhythm control
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 21 Jun 2021 14:37
Last Modified: 18 Jan 2023 22:33
DOI: 10.20452/pamw.15146
Open Access URL: https://www.mp.pl/paim/issue/article/15146/
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3127191