Humphries Brittany, Cox Jafna L, Parkash Ratika, Thabane Lehana, Foster Gary A, MacKillop James, Nemis-White Joanna, Hamilton Laura, Ciaccia Antonio, Choudhri Shurjeel H, Xie Feng
Department of Health Research Methods, Evidence and Impact McMaster University Hamilton ON Canada.
Division of Cardiology Department of Medicine Dalhousie University Halifax NS Canada.
J Am Heart Assoc. 2021 Aug 3;10(15):e019783. doi: 10.1161/JAHA.120.019783. Epub 2021 Jul 28.
Background The IMPACT-AF (Integrated Management Program Advancing Community Treatment of Atrial Fibrillation) trial is a prospective, randomized, cluster design trial comparing atrial fibrillation management with a computerized clinical decision support system with usual care (control) in the primary care setting of Nova Scotia, Canada. The objective of this analysis was to assess and compare patient-reported health-related quality of life and patient-reported experience with atrial fibrillation care between clinical decision support and control groups. Methods and Results Health-related quality of life was measured using the EuroQol 5-dimensional 5-level scale, whereas patient-reported experience was assessed using a self-administered satisfaction questionnaire, both assessed at baseline and 12 months. Health utilities were calculated using the Canadian EuroQol 5-dimensional 5-level value set. Descriptive statistics and generalized estimating equations were used to compare between groups. Among 1145 patients enrolled in the trial, 717 had complete EuroQol 5-dimensional 5-level data at baseline. The mean age of patients was 73.53 years, and 61.87% were men. Mean utilities at baseline were 0.809 (SD, 0.157) and 0.814 (SD, 0.157) for clinical decision support and control groups, respectively. At baseline, most patients in both groups reported being "very satisfied" with the care received for their atrial fibrillation. There were no statistically significant differences in utility scores or patient satisfaction between groups at 12 months. Conclusions Health-related quality of life of patients remained stable over 12 months, and there was no significant difference in patient satisfaction or utility scores between clinical decision support and control groups. Registration information clinicaltrials.gov. Identifier: NCT01927367.
IMPACT-AF(推进心房颤动社区治疗综合管理项目)试验是一项前瞻性、随机、整群设计试验,在加拿大新斯科舍省的初级医疗环境中,比较使用计算机化临床决策支持系统管理心房颤动与常规治疗(对照)的效果。本分析的目的是评估和比较临床决策支持组与对照组患者报告的健康相关生活质量以及患者报告的心房颤动护理体验。
使用欧洲五维健康量表(EuroQol 5-dimensional 5-level scale)测量健康相关生活质量,同时使用一份自我管理的满意度问卷评估患者报告的体验,两者均在基线和12个月时进行评估。使用加拿大欧洲五维健康量表值集计算健康效用值。采用描述性统计和广义估计方程进行组间比较。在试验招募的1145例患者中,717例在基线时有完整的欧洲五维健康量表数据。患者的平均年龄为73.53岁。临床决策支持组和对照组基线时的平均健康效用值分别为0.809(标准差,0.157)和0.814(标准差,0.157)。基线时,两组中大多数患者对所接受的心房颤动护理表示“非常满意”。12个月时,两组间的效用得分或患者满意度无统计学显著差异。
患者的健康相关生活质量在12个月内保持稳定,临床决策支持组与对照组在患者满意度或效用得分方面无显著差异。注册信息:clinicaltrials.gov。标识符:NCT01927367。