AF at Home: A Virtual Education Program for Patients With Atrial Fibrillation (AF)
Improving Outpatient Comprehensive Atrial Fibrillation Care Across Central North Carolina Through Direct Primary Care and Patient Engagement
The goal of this study is to determine the effectiveness of a direct-to-patient virtual education program ("AF at Home") for adults with atrial fibrillation (AF). The main questions this study aims to answer are:
- Will participants in the educational program have improvement in quality of life, self-monitoring, and self-management strategies after program completion?
- Will patient level quality of AF care improve for participants in the educational program?
Participants will be asked to:
- Participate in six hours of virtual education sessions over three weeks via Zoom.
- Complete online questionnaires before the program starts and after its completion.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Tiffany Armbruster, AGNP
- Phone Number: 984-974-4743
- Email: tiffany_armbruster@med.unc.edu
Study Locations
-
-
North Carolina
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Chapel Hill, North Carolina, United States, 27599
- University of North Carolina, Chapel Hill
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Durham, North Carolina, United States, 27710
- Duke University
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Winston-Salem, North Carolina, United States, 27109
- Wake Forest University
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient with diagnosis of non-valvular or valvular atrial fibrillation
- Age >/= 18
Exclusion Criteria:
- Unable to provide informed consent
- Incarcerated patient
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: AF at Home
All recruited participants will participate in the AF at Home educational intervention.
|
The AF at Home education program will be delivered via Zoom videoconferencing technology and will include 6, 1-hour long sessions that involve education on AF self-monitoring and self-management.
Each session will include a didactic presentation and open Q&A.
Supplementary educations materials will be made available to participants.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change Atrial Fibrillation Effect on Quality-of-life Questionnaire (AFEQT) Score
Time Frame: Baseline and 3 weeks
|
The AFEQT questionnaire is a validated tool used to measure self-reported quality of life specifically for patients with atrial fibrillation.
The questionnaire includes 20 questions measured on a 7-point Likert scale (1= not at all to 7=extremely) with 3 subcategories.
The subcategories include symptoms (questions 1-4), daily activities (questions 5-12), and treatment concerns (questions 13-18).
Scoring provides an overall AFEQT score (based on questions 1-18), and a treatment satisfaction score (based on questions 19-20).
Treatment satisfaction scores are not included in the overall AFEQT score.
Overall or subcategory scores range from 0-100.
A score of 100 corresponds to no disability, and a score of 0 corresponds to total disability.
|
Baseline and 3 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) Global Pain Intensity Scores
Time Frame: Baseline and 3 weeks
|
The PROMIS-29 questionnaire measures pain intensity across 7 domains with 4 questions in each domain (physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, and pain interference), and one global pain intensity question.
Each domain score ranges from 4-20 with higher scores indicating more of the symptom being measured.
Global pain intensity score ranges from 0-10 (0-no pain to 10=highest pain level).
|
Baseline and 3 weeks
|
|
Change in Cardiac Anxiety Questionnaire (CAQ)
Time Frame: Baseline and 3 weeks
|
The CAQ is a self-reported measure that assesses anxiety related specifically to cardiac symptoms.
The CAQ contains 18 questions rated on a 5-point Likert scale (0=never to 4=always).
The questionnaire contains 3 subcategories including fear (8 questions), avoidance (5 questions), and attention (5 questions).
The higher the score, the more symptoms and or frequency.
|
Baseline and 3 weeks
|
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Number of Patients Prescribed Appropriate Anticoagulation
Time Frame: Baseline and 1-year post intervention session 6
|
This outcome measures the Number of patients prescribed appropriate anticoagulation medication based on risk factors for stroke including congestive heart failure (C), hypertension (H), Age >74 (A2), Diabetes (D), prior stroke or transient ischemic attack (TIA) (S2), vascular disease (V), age 65-74 (A), female sex (Sc), commonly referred to as CHA2DS2-VASc stroke risk score for patients with atrial fibrillation.
CHA2DS2-VASc score includes 7 indicators of stroke risk (age (<65=0, 65-74=1, 75+= 2), sex (male=0, female=1), heart failure (no=0, yes=1), hypertension (no=0, yes=1), prior stroke/TIA (no=0, yes=2), history of vascular disease (no=0, yes=1), and diabetes (no=0, yes=1).
Anticoagulation is indicated for a female with a score 3 or higher and males with a score of 2 or higher.
This information will be collected from electronic health records.
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Baseline and 1-year post intervention session 6
|
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Number of Patients Prescribed Antiplatelet Therapy for AF Stroke Risk Reduction
Time Frame: Baseline and 1-year post intervention session 6
|
This outcome will measure the number of patients who were prescribed antiplatelet therapy for atrial fibrillation stroke risk reduction without comorbid vascular disease.
This information will be collected from electronic health records.
|
Baseline and 1-year post intervention session 6
|
|
Number of Patients with Achievement of Blood Pressure at Target
Time Frame: Baseline and 1-year post intervention session 6
|
This outcome will measure the number of patients meeting guideline blood pressure target of systolic blood pressure (SBP) <130 mmHg.This information will be collected from electronic health records.
|
Baseline and 1-year post intervention session 6
|
|
Number of Patients with Achievement of Heart Rate Target
Time Frame: Baseline and 1-year post intervention session 6
|
This outcome will measure the number of patients meeting guideline heart rate target of <110 beats per minute (bpm).
This information will be collected from electronic health records.
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Baseline and 1-year post intervention session 6
|
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Number of Patients Prescribed Rhythm Controlling Medications
Time Frame: Baseline and 1-year post intervention session 6
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This outcome will measure the number of patients who are prescribed rhythm controlling medications.
This information will be collected from electronic health records.
|
Baseline and 1-year post intervention session 6
|
|
Number of Emergency Department Visits or Hospital Admissions for AF or Stroke (Healthcare Utilization)
Time Frame: Baseline and 1-year post intervention session 6
|
This outcome will measure the number of emergency room visits and/or hospital admissions with a primary or secondary diagnosis of atrial fibrillation or stroke.
This information will be collected from electronic health records.
|
Baseline and 1-year post intervention session 6
|
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Change in Confidence in Atrial Fibrillation Management (CALM) Scale
Time Frame: Baseline and 3 weeks
|
The CALM scale is a newly developed tool to assess self-reported confidence in self-management skills for patients with AF.
The CALM scale contains 16 questions to indicate the level of confidence in each item on a range of 0-4 (not confident =0, to extremely confident=3).
The higher the score, the more confident in self-management skills.
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Baseline and 3 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Anil Gehi, MD, University of North Carolina, Chapel Hill
Publications and helpful links
General Publications
- Gallagher C, Rowett D, Nyfort-Hansen K, Simmons S, Brooks AG, Moss JR, Middeldorp ME, Hendriks JM, Jones T, Mahajan R, Lau DH, Sanders P. Patient-Centered Educational Resources for Atrial Fibrillation. JACC Clin Electrophysiol. 2019 Oct;5(10):1101-1114. doi: 10.1016/j.jacep.2019.08.007. Epub 2019 Sep 1.
- Tripp C, Gehi AK, Rosman L, Anthony S, Sears SF. Measurement of patient confidence in self-management of atrial fibrillation: Initial validation of the Confidence in Atrial fibriLlation Management (CALM) Scale. J Cardiovasc Electrophysiol. 2021 Jun;32(6):1640-1645. doi: 10.1111/jce.15050. Epub 2021 May 12.
- Rosman L, Armbruster T, Kyazimzade S, Tugaoen Z, Mazzella AJ, Deyo Z, Walker J, Machineni S, Gehi A. Effect of a virtual self-management intervention for atrial fibrillation during the outbreak of COVID-19. Pacing Clin Electrophysiol. 2021 Mar;44(3):451-461. doi: 10.1111/pace.14188. Epub 2021 Feb 17.
- January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, Ellinor PT, Ezekowitz MD, Field ME, Furie KL, Heidenreich PA, Murray KT, Shea JB, Tracy CM, Yancy CW. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation. 2019 Jul 9;140(2):e125-e151. doi: 10.1161/CIR.0000000000000665. Epub 2019 Jan 28. No abstract available.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 22-1350b
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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