Effect of Targeted Education of Patients with Atrial Fibrillation on Unplanned Cardiovascular Outcomes: Results of the Multicentre Randomized AF-EduCare Trial

Overview

Journal Europace

Publisher Oxford University Press

Date 2025 Jan 20

PMID 39832209

Authors

Lien Desteghe

Michiel Delesie

Lieselotte Knaepen

Rana Onder

Johan Verbeeck

Paul Dendale

Thomas Phlips

Peter Haemers

Johan Saenen

Joris Ector

Johan Vijgen

Hein Heidbuchel

Affiliations

Soon will be listed here.

Abstract

Aims: Trials on integrated care for atrial fibrillation (AF) showed mixed results in different AF populations using various approaches. The multicentre, randomized AF-EduCare trial evaluated the effect of targeted patient education on unplanned cardiovascular outcomes.

Methods And Results: Patients willing to participate were randomly assigned to in-person education, online education, or standard care (SC) and followed for minimum 18 months. Education focused on four aspects of integrated AF care: (i) knowledge on AF and oral anticoagulation; (ii) reinforcement of medication adherence; (iii) awareness about risk factors; and (iv) reachability for AF-related questions. The primary endpoint was the composite of cumulative events of unplanned cardiovascular hospitalizations and consultations, emergency department visits for cardiovascular reasons, and cardiovascular death. A total of 1038 patients (69.8 ± 9.2 years) were followed up for 26.9 ± 9.4 months. Education (both in-person and online) significantly improved AF-related knowledge compared to SC (P < 0.001), increased patient awareness about risk factors, led to high medication adherence, and encouraged patients to ask health-related questions. However, in-person education did not show an effect on the primary outcome compared to SC [HR 1.02 (0.91-1.14); P = 0.80] that was also not the case when comparing online education vs. SC [HR 1.18 (0.95-1.46), P = 0.65]. Exploratory subgroup analyses showed a heterogeneous effect over the centres, but a positive impact of in-person education in patients with asymptomatic AF, being 70 years old or younger, and without a history of heart failure.

Conclusion: AF-EduCare showed that intensive targeted patient education did not lead to less unplanned cardiovascular events in the AF patient population as a whole, although subgroups might benefit.

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