Use of Evidence-Based Therapy for Cardiovascular Risk Factors in Canadian Outpatients With Atrial Fibrillation: From the Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation (FREEDOM AF) and Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation (CONNECT AF)

Am J Cardiol. 2017 Aug 15;120(4):582-587. doi: 10.1016/j.amjcard.2017.05.027. Epub 2017 Jun 1.

Abstract

Using data collected from 2 national atrial fibrillation (AF) primary care physician chart audits (Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation [FREEDOM AF] and Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation [CONNECT AF]), we evaluated the frequency of, and factors associated with, the use of cardiovascular (CV) evidence-based therapies in Canadian AF outpatients with at least 1 CV risk factor or co-morbidity. Of the 11,264 patients enrolled, 9,495 (84.3%) were eligible for one or more CV evidence-based therapies. The proportions of patients with AF receiving all eligible guideline-recommended therapies were 40.8% of patients with coronary artery disease, 48.9% of patients with diabetes mellitus, 40.2% of patients with heart failure, 96.7% of patients with hypertension, and 55.1% of patients with peripheral arterial disease. Factors that were independently associated with nonreceipt of all indicated evidence-based therapies included sinus rhythm rather than AF at baseline and liver disease. In conclusion, although most Canadian outpatients with AF have CV risk factors or co-morbidities, a substantial portion of these patients did not receive all guideline-recommended therapies. These findings suggest that there is an opportunity to improve the quality of care for patients with AF in Canada.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / therapy*
  • Canada / epidemiology
  • Clinical Competence
  • Evidence-Based Medicine / standards*
  • Female
  • Humans
  • Incidence
  • Male
  • Outpatients*
  • Physicians, Primary Care / education*
  • Physicians, Primary Care / standards
  • Practice Guidelines as Topic*
  • Program Evaluation
  • Registries
  • Risk Assessment*
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / prevention & control*