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Variations in Documentation of Atrial Fibrillation Predicted by Population and Service Level Characteristics in Primary Health Care in England

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Specialty Public Health
Date 2022 Feb 15
PMID 35165736
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Abstract

Background: Identifying features associated with atrial fibrillation (AF) documentation could inform screening. This study used published data to describe differences in documented and estimated AF prevalence in general practices, and explored predictors of variations in AF prevalence.

Methods: Cross-sectional study of 7318 general practices in England. Descriptive and inferential statistics were undertaken. Multiple linear regression was used to model the difference between estimated AF and documented AF, adjusted for population, practice and practice performance variables.

Results: Documented AF prevalence was lower than estimated (- 0.55% 95% confidence intervals, -1.89, 2.99). The proportion of variability accounted for in the final regression model was 0.25. Factors positively associated with AF documentation (increase in difference between estimated and documented), were patients 65-74 years, 75 years +, Black or South Asian ethnicity, diabetes mellitus and practices in East and Midlands of England. Eight variables (female patients, deprivation score, heart failure and peripheral artery disease, total patients per practice, full-time GPs and nurses; and location in South of England) were negatively associated with AF documentation (reduction in difference).

Conclusion: Variations in AF documentation were predicted by several practice and population characteristics. Screening could target these sources of variation to decrease variation and improve AF documentation.

References
1.
Kavousi M . Differences in Epidemiology and Risk Factors for Atrial Fibrillation Between Women and Men. Front Cardiovasc Med. 2020; 7:3. PMC: 7025483. DOI: 10.3389/fcvm.2020.00003. View

2.
Stewart S, Murphy N, Murphy N, Walker A, McGuire A, McMurray J . Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart. 2004; 90(3):286-92. PMC: 1768125. DOI: 10.1136/hrt.2002.008748. View

3.
Martinez C, Katholing A, Wallenhorst C, Granziera S, Cohen A, Freedman S . Increasing incidence of non-valvular atrial fibrillation in the UK from 2001 to 2013. Heart. 2015; 101(21):1748-54. DOI: 10.1136/heartjnl-2015-307808. View

4.
. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized controlled trials. Arch Intern Med. 1994; 154(13):1449-57. View

5.
Schnabel R, Sullivan L, Levy D, Pencina M, Massaro J, DAgostino Sr R . Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study. Lancet. 2009; 373(9665):739-45. PMC: 2764235. DOI: 10.1016/S0140-6736(09)60443-8. View