A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation

Brigitte Fong Yeong Woo, Wilson Wai San Tam, Taiju Rangpa, Wei Fong Liau, Jennifer Nathania and Toon Wei Lim
Additional contact information
Brigitte Fong Yeong Woo: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
Wilson Wai San Tam: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
Taiju Rangpa: Bukit Batok—Medical, National University Polyclinics, National University Health System, Singapore 659164, Singapore
Wei Fong Liau: Bukit Batok—Nursing, National University Polyclinics, National University Health System, Singapore 659164, Singapore
Jennifer Nathania: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
Toon Wei Lim: Department of Cardiology, National University Heart Centre, National University Health System, Singapore 119228, Singapore

IJERPH, 2022, vol. 19, issue 8, 1-15

Abstract: The current physician-centric model of care is not sustainable for the rising tide of atrial fibrillation. The integrated model of care has been recommended for managing atrial fibrillation. This study aims to provide a preliminary evaluation of the effectiveness of a Nurse-led Integrated Chronic care E-enhanced Atrial Fibrillation (NICE-AF) clinic in the community. The NICE-AF clinic was led by an advanced practice nurse (APN) who collaborated with a family physician. The clinic embodied integrated care and shifted from hospital-based, physician-centric care. Regular patient education, supplemented by a specially curated webpage, fast-tracked appointments for hospital-based specialised investigations, and teleconsultation with a hospital-based cardiologist were the highlights of the clinic. Forty-three participants were included in the six-month preliminary evaluation. No significant differences were observed in cardiovascular hospitalisations ( p -value = 0.102) and stroke incidence ( p -value = 1.00) after attending the NICE-AF clinic. However, significant improvements were noted for AF-specific QoL ( p = 0.001), AF knowledge ( p < 0.001), medication adherence ( p = 0.008), patient satisfaction ( p = 0.020), and depression ( p = 0004). The preliminary evaluation of the NICE-AF clinic demonstrated the clinical utility of this new model of integrated care in providing safe and effective community-based AF care. Although a full evaluation is pending, the preliminary results highlighted its promising potential to be expanded into a permanent, larger-scale service.

Keywords: atrial fibrillation; nurse-led; integrated care; advanced practice nurse (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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