Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
Division of Cardiology, Jiangdu People's Hospital, Yangzhou, People's Republic of China.
Vasc Health Risk Manag. 2022 Sep 15;18:757-766. doi: 10.2147/VHRM.S379182. eCollection 2022.
China has a large population of elderly in rural areas. Village doctors are acting as health-care gatekeepers for the rural elderly in China and are encouraged to provide more long-term care for patients with chronic diseases such as atrial fibrillation (AF). The data of AF registries from the rural elderly are limited. The present registry aims to provide contemporary data on the current AF-related health status of the rural elderly and the gaps in management of AF by village doctors. This study has two phases. The first phase is a cross-sectional study of AF screening in two rural towns of eastern China. All the residents aged ≥65 years are eligible and will be invited to attend a government-led health examination or an in-house AF screening program. The AF detection rate, the awareness of AF and the usage of oral anticoagulants and smartphones by AF patients, and the ability to diagnose and manage AF by village doctors will be assessed. Participants with AF detected in the first phase are eligible for the second phase. A variety of modes of intensified education will be provided to all AF patients and their family members to enrich their AF-related knowledge. Their village doctors will be offered a lecture-based training program focusing on Atrial fibrillation Better Care (ABC) pathway. Follow-up will be conducted for 1 year. The primary endpoint is the composite of all stroke and all-cause mortality. The first phase of AF screening was conducted between April 2019 and June 2019, and 18,712 participants with the mean age of 73.1±5.8 years were enrolled. The second phase that includes 810 patients with AF, started on 1 May 2019. This study will provide a perspective of primary care system and would indirectly reflect the current status of chronic disease care in rural China.
中国农村地区有大量的老年人口。乡村医生是中国农村老年人的健康守门人，鼓励他们为房颤（AF）等慢性病患者提供更多的长期护理。农村老年人的 AF 登记数据有限。本登记研究旨在提供当前农村老年人 AF 相关健康状况以及乡村医生管理 AF 差距的当代数据。该研究分为两个阶段。第一阶段是在中国东部两个农村城镇进行的 AF 筛查的横断面研究。所有年龄≥65 岁的居民都有资格参加政府主导的健康检查或内部 AF 筛查计划。将评估 AF 检出率、AF 知晓率和 AF 患者口服抗凝剂和智能手机的使用率，以及乡村医生诊断和管理 AF 的能力。在第一阶段检测到 AF 的参与者有资格参加第二阶段。将向所有 AF 患者及其家属提供各种强化教育模式，以丰富他们的 AF 相关知识。将为他们的乡村医生提供一个以心房颤动更好护理（ABC）途径为重点的基于讲座的培训计划。随访时间为 1 年。主要终点是所有中风和全因死亡率的复合终点。AF 筛查的第一阶段于 2019 年 4 月至 6 月进行，共纳入 18712 名平均年龄为 73.1±5.8 岁的参与者。第二阶段包括 810 名 AF 患者，于 2019 年 5 月 1 日开始。本研究将提供初级保健系统的视角，并间接地反映中国农村慢性病护理的现状。
