AIMS: Incorporating patient-reported outcomes (PROs) into routine care of atrial fibrillation (AF) enables direct integration of symptoms, function, and health-related quality of life (HRQoL) into practice. We report our initial experience with a system-wide PRO initiative among AF patients. METHODS AND RESULTS: All patients with AF in our practice undergo PRO assessment with the Toronto AF Severity Scale (AFSS), and generic PROs, prior to electrophysiology clinic visits. We describe the implementation, feasibility, and results of clinic-based, electronic AF PRO collection, and compare AF-specific and generic HRQoL assessments. From October 2016 to February 2019, 1586 unique AF patients initiated 2379 PRO assessments, 2145 of which had all PRO measures completed (90%). The median completion time for all PRO measures per visit was 7.3 min (1st, 3rd quartiles: 6, 10). Overall, 38% of patients were female (n = 589), mean age was 68 (SD 12) years, and mean CHA2DS2-VASc score was 3.8 (SD 2.0). The mean AFSS symptom score was 8.6 (SD 6.6, 1st, 3rd quartiles: 3, 13), and the full range of values was observed (0, 35). Generic PROs of physical function, general health, and depression were impacted at the most severe quartiles of AF symptom score (P < 0.0001 for each vs. AFSS quartile). CONCLUSION: Routine clinic-based, PRO collection for AF is feasible in clinical practice and patient time investment was acceptable. Disease-specific AF PROs add value to generic HRQoL instruments. Further research into the relationship between PROs, heart rhythm, and AF burden, as well as PRO-guided management, is necessary to optimize PRO utilization. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Incorporating patient-reported outcomes (PROs) into routine care of atrial fibrillation (AF) enables direct integration of symptoms, function, and health-related quality of life (HRQoL) into practice. We report our initial experience with a system-wide PRO initiative among AFpatients. METHODS AND RESULTS: All patients with AF in our practice undergo PRO assessment with the Toronto AF Severity Scale (AFSS), and generic PROs, prior to electrophysiology clinic visits. We describe the implementation, feasibility, and results of clinic-based, electronic AFPRO collection, and compare AF-specific and generic HRQoL assessments. From October 2016 to February 2019, 1586 unique AFpatients initiated 2379 PRO assessments, 2145 of which had all PRO measures completed (90%). The median completion time for all PRO measures per visit was 7.3 min (1st, 3rd quartiles: 6, 10). Overall, 38% of patients were female (n = 589), mean age was 68 (SD 12) years, and mean CHA2DS2-VASc score was 3.8 (SD 2.0). The mean AFSS symptom score was 8.6 (SD 6.6, 1st, 3rd quartiles: 3, 13), and the full range of values was observed (0, 35). Generic PROs of physical function, general health, and depression were impacted at the most severe quartiles of AF symptom score (P < 0.0001 for each vs. AFSS quartile). CONCLUSION: Routine clinic-based, PRO collection for AF is feasible in clinical practice and patient time investment was acceptable. Disease-specific AF PROs add value to generic HRQoL instruments. Further research into the relationship between PROs, heart rhythm, and AF burden, as well as PRO-guided management, is necessary to optimize PRO utilization. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: P Dorian; W Jung; D Newman; M Paquette; K Wood; G M Ayers; J Camm; M Akhtar; B Luderitz Journal: J Am Coll Cardiol Date: 2000-10 Impact factor: 24.094
Authors: Benjamin A Steinberg; Paul Dorian; Kevin J Anstrom; Rachel Hess; Daniel B Mark; Peter A Noseworthy; John A Spertus; Jonathan P Piccini Journal: JACC Clin Electrophysiol Date: 2019-05-01
Authors: David Cella; William Riley; Arthur Stone; Nan Rothrock; Bryce Reeve; Susan Yount; Dagmar Amtmann; Rita Bode; Daniel Buysse; Seung Choi; Karon Cook; Robert Devellis; Darren DeWalt; James F Fries; Richard Gershon; Elizabeth A Hahn; Jin-Shei Lai; Paul Pilkonis; Dennis Revicki; Matthias Rose; Kevin Weinfurt; Ron Hays Journal: J Clin Epidemiol Date: 2010-08-04 Impact factor: 6.437
Authors: Elena Birman-Deych; Amy D Waterman; Yan Yan; David S Nilasena; Martha J Radford; Brian F Gage Journal: Med Care Date: 2005-05 Impact factor: 2.983
Authors: Daniel B Mark; Kevin J Anstrom; Shubin Sheng; Jonathan P Piccini; Khaula N Baloch; Kristi H Monahan; Melanie R Daniels; Tristram D Bahnson; Jeanne E Poole; Yves Rosenberg; Kerry L Lee; Douglas L Packer Journal: JAMA Date: 2019-04-02 Impact factor: 56.272
Authors: Ayman A Hussein; Bruce Lindsay; Ruth Madden; David Martin; Walid I Saliba; Khaldoun G Tarakji; Bilal Saqi; David J Rausch; Thomas Dresing; Thomas Callahan; Mina K Chung; Bryan Baranowski; Mandeep Bhargava; Daniel Cantillon; John Rickard; Mohamed Kanj; Patrick Tchou; Bruce L Wilkoff; Steven E Nissen; Oussama M Wazni Journal: Circ Arrhythm Electrophysiol Date: 2019-03
Authors: Melanie Calvert; Derek Kyte; Rebecca Mercieca-Bebber; Anita Slade; An-Wen Chan; Madeleine T King; Amanda Hunn; Andrew Bottomley; Antoine Regnault; An-Wen Chan; Carolyn Ells; Daniel O'Connor; Dennis Revicki; Donald Patrick; Doug Altman; Ethan Basch; Galina Velikova; Gary Price; Heather Draper; Jane Blazeby; Jane Scott; Joanna Coast; Josephine Norquist; Julia Brown; Kirstie Haywood; Laura Lee Johnson; Lisa Campbell; Lori Frank; Maria von Hildebrand; Michael Brundage; Michael Palmer; Paul Kluetz; Richard Stephens; Robert M Golub; Sandra Mitchell; Trish Groves Journal: JAMA Date: 2018-02-06 Impact factor: 56.272
Authors: Josef Stehlik; Carlos Rodriguez-Correa; John A Spertus; Joshua Biber; Jose Nativi-Nicolau; Susan Zickmund; Benjamin A Steinberg; David C Peritz; Andrew Walker; Jordan Hess; Stavros G Drakos; Abdallah G Kfoury; James C Fang; Craig H Selzman; Rachel Hess Journal: J Card Fail Date: 2017-10-02 Impact factor: 5.712
Authors: Benjamin A Steinberg; Zhen Li; Peter Shrader; Derek S Chew; T Jared Bunch; Daniel B Mark; Yelena Nabutovsky; Rashmee U Shah; Melissa A Greiner; Jonathan P Piccini Journal: Am Heart J Date: 2021-11-25 Impact factor: 4.749
Authors: Benjamin A Steinberg; Shannon Woolley; Haojia Li; Candice Crawford; Christopher A Groh; Leenhapong Navaravong; Ravi Ranjan; Brian Zenger; Yue Zhang; T Jared Bunch Journal: J Cardiovasc Electrophysiol Date: 2022-05-30 Impact factor: 2.942
Authors: Benjamin A Steinberg; Mingyuan Zhang; Jason Bensch; Ann Lyons; T Jared Bunch; Jonathan P Piccini; Alfonso Siu; John A Spertus; Josef Stehlik; Peter Wohlfahrt; Tom Greene; Rachel Hess; James C Fang Journal: J Card Fail Date: 2021-07-26 Impact factor: 5.712
Authors: Brian Zenger; Mingyuan Zhang; Ann Lyons; T Jared Bunch; James C Fang; Roger A Freedman; Leenhapong Navaravong; Jonathan P Piccini; Ravi Ranjan; John A Spertus; Josef Stehlik; Jeffrey L Turner; Tom Greene; Rachel Hess; Benjamin A Steinberg Journal: J Cardiovasc Electrophysiol Date: 2020-11-11