TY - JOUR
T1 - Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region
T2 - the BALKAN-AF survey
AU - Kozieł, Monika
AU - Simovic, Stefan
AU - Pavlovic, Nikola
AU - Kocijancic, Aleksander
AU - Paparisto, Vilma
AU - Music, Ljilja
AU - Trendafilova, Elina
AU - Dan, Anca R
AU - Kusljugic, Zumreta
AU - Dan, Gheorghe-Andrei
AU - Lip, Gregory Y H
AU - Potpara, Tatjana S
AU - BALKAN‑AF Investigators
PY - 2020/3/27
Y1 - 2020/3/27
N2 - INTRODUCTION: The Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management.OBJECTIVES: To evaluate adherence to the ABC pathway and to determine major gaps in adherence in patients in the BALKAN‑AF survey.PATIENTS AND METHODS: 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.RESULTS: 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).CONCLUSIONS: 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.
AB - INTRODUCTION: The Atrial fibrillation Better Care (ABC) pathway provides a useful way of simplifying decision‑making considerations in a holistic approach to atrial fibrillation management.OBJECTIVES: To evaluate adherence to the ABC pathway and to determine major gaps in adherence in patients in the BALKAN‑AF survey.PATIENTS AND METHODS: 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.RESULTS: 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).CONCLUSIONS: 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.
KW - Atrial fibrillation
KW - BALKAN-AF survey
KW - Oral anticoagulants
KW - Rate control
KW - Rhythm control
U2 - 10.20452/pamw.15146
DO - 10.20452/pamw.15146
M3 - Journal article
C2 - 31969552
SN - 0032-3772
VL - 130
SP - 187
EP - 195
JO - Polskie Archiwum Medycyny Wewnetrznej
JF - Polskie Archiwum Medycyny Wewnetrznej
IS - 3
ER -