STEEER-AF 试验的设计和部署：旨在评估和改善指南依从性的欧洲心脏病学会和欧洲心律协会的一项集群随机试验。
Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association.
机构信息
Arrhythmia Center, National Institute of Cardiology, Warsaw, Poland.
Institute of Cardiovascular Sciences, University of Birmingham, Medical School, Vincent Drive, Birmingham B15 2TT, UK.
出版信息
Europace. 2024 Jul 2;26(7). doi: 10.1093/europace/euae178.
AIMS
The aim is to describe the rationale, design, delivery, and baseline characteristics of the Stroke prevention and rhythm control Treatment: Evaluation of an Educational programme of the European society of cardiology in a cluster-Randomized trial in patients with Atrial Fibrillation (STEEER-AF) trial.
METHODS AND RESULTS
STEEER-AF is a pragmatic trial designed to objectively and robustly determine whether guidelines are adhered to in routine practice and evaluate a targeted educational programme for healthcare professionals. Seventy centres were randomized in six countries (France, Germany, Italy, Poland, Spain, and UK; 2022-23). The STEEER-AF centres recruited 1732 patients with a diagnosis of atrial fibrillation (AF), with a mean age of 68.9 years (SD 11.7), CHA2DS2-VASc score of 3.2 (SD 1.8), and 647 (37%) women. Eight hundred and forty-three patients (49%) were in AF at enrolment and 760 (44%) in sinus rhythm. Oral anticoagulant therapy was prescribed in 1543 patients (89%), with the majority receiving direct oral anticoagulants (1378; 89%). Previous cardioversion, antiarrhythmic drug therapy, or ablation was recorded in 836 patients (48.3%). Five hundred fifty-one patients (31.8%) were currently receiving an antiarrhythmic drug, and 446 (25.8%) were scheduled to receive a future cardioversion or ablation. The educational programme engaged 195 healthcare professionals across centres randomized to the intervention group, consisting of bespoke interactive online learning and reinforcement activities, supported by national expert trainers.
CONCLUSION
The STEEER-AF trial was successfully deployed across six European countries to investigate guideline adherence in real-world practice and evaluate if a structured educational programme for healthcare professionals can improve patient-level care.
CLINICAL TRIAL REGISTRATION
Clinicaltrials.gov, NCT04396418.
目的
描述欧洲心脏病学会在一项随机对照试验中进行的房颤患者卒中预防和节律控制治疗：评估教育计划的基本原理、设计、实施和基线特征。
方法和结果
STEEER-AF 是一项实用的试验，旨在客观和稳健地确定指南在常规实践中是否得到遵守，并评估针对医疗保健专业人员的有针对性的教育计划。该试验在六个国家（法国、德国、意大利、波兰、西班牙和英国；2022-2023 年）的 70 个中心进行了随机分组。STEEER-AF 中心招募了 1732 名诊断为房颤（AF）的患者，平均年龄 68.9 岁（SD 11.7），CHA2DS2-VASc 评分为 3.2（SD 1.8），647 名（37%）为女性。843 名患者（49%）在入组时处于 AF 状态，760 名（44%）处于窦性节律。1543 名患者（89%）接受了口服抗凝治疗，其中大多数接受了直接口服抗凝剂（1378 名；89%）。836 名患者（48.3%）记录了以前的电复律、抗心律失常药物治疗或消融。551 名患者（31.8%）目前正在服用抗心律失常药物，446 名患者（25.8%）计划接受未来的电复律或消融。该教育计划在随机分组到干预组的 195 名医疗保健专业人员中实施，包括定制的互动在线学习和强化活动，并由国家专家培训师提供支持。
结论
STEER-AF 试验在六个欧洲国家成功部署，以调查真实世界实践中的指南依从性，并评估针对医疗保健专业人员的结构化教育计划是否可以改善患者层面的护理。
临床试验注册
Clinicaltrials.gov，NCT04396418。
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