Reaching Frail Elderly Patients to Optimize Diagnosis and Management of Atrial Fibrillation (REAFEL): A Feasibility Study of a Cross-Sectoral Shared-Care Model

Caroline Thorup Ladegaard, Carsten Bamberg, Mathias Aalling, Dorthea Marie Jensen, Nina Kamstrup-Larsen, Christoffer Valdorff Madsen, Sadaf Kamil, Henrik Gudbergsen, Thomas Saxild, Michaela Louise Schiøtz, Julie Grew, Luana Sandoval Castillo, Anne Frølich and Helena Domínguez
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Caroline Thorup Ladegaard: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark
Carsten Bamberg: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark
Mathias Aalling: VihTek Research Center for Welfare Technology Region, 2600 Hovedstaden, Denmark
Dorthea Marie Jensen: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark
Nina Kamstrup-Larsen: Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Region Zealand, 4180 Sorø, Denmark
Christoffer Valdorff Madsen: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark
Sadaf Kamil: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark
Henrik Gudbergsen: The Parker Institute Bispebjerg and Frederiksberg Hospital Copenhagen Denmark, Section of General Practice, Department of Public Health, University of Copenhagen, 1165 Copenhagen, Denmark
Thomas Saxild: Grøndahlslægerne Godthåbsvej 239a Vanløse, 2720 Copenhagen, Denmark
Michaela Louise Schiøtz: Center for Clinical Research and Prevention Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2400 Copenhagen, Denmark
Julie Grew: Center for Clinical Research and Prevention Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2400 Copenhagen, Denmark
Luana Sandoval Castillo: Geriatrics Department, Bispebjerg Hospital, 2400 Copenhagen, Denmark
Anne Frølich: Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Region Zealand, 4180 Sorø, Denmark
Helena Domínguez: Cardiology Department Y Bispebjerg and Frederiksberg, Hospital Copenhagen Denmark, 2000 Frederiksberg, Denmark

IJERPH, 2022, vol. 19, issue 12, 1-10

Abstract: Introduction: Atrial fibrillation (AF) management in primary care often requires a referral to cardiology clinics, which can be strenuous for frail patients. We developed “ cardio-share ” (CS), a new cross-sector collaboration model, to ease this process. General practitioners (GPs) can use a compact Holter monitor (C3 from Cortrium) to receive remote advice from the cardiologist. Objective: To test the feasibility and acceptability of the CS model to manage suspected AF in frail elderly patients. Methods: We used a mixed methods design, including the preparation of qualitative semistructured interviews of GPs and nurses. Results: Between MAR-2019 and FEB-2020, 54 patients were consulted through the CS model, of whom 35 underwent C3 Holter monitoring. The time from referral to a final Holter report was shortened from a mean (SD) of 117 (45) days in usual care to 30 days (13) with the CS model. Furthermore, 90% of the patients did not need to attend visits at the cardiology clinic. The GPs and nurses highlighted the ease of using the C3 monitor. Their perception was that patients were confident in the GPs’ collaboration with cardiologists. Conclusions : The CS model using a C3 monitor for AF is both feasible and seems acceptable to GPs. The elapsed time from referral to the Holter report performed for the diagnosis was significantly reduced.

Keywords: sensor Holter monitoring; atrial fibrillation; health professionals; frail elderly patients; cross-sector collaboration (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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