Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 1;34(10):1139-1148.
doi: 10.1097/JXX.0000000000000779.

Health care utilization in a nurse practitioner-led atrial fibrillation clinic

David B Meyer  1 , Michael C Larkins  1 , Omar Taha  1 , Amber Seiler  2 , Sheryl Booth  2 , Robert B Hokanson  3 , James Allred  2
Affiliations

Health care utilization in a nurse practitioner-led atrial fibrillation clinic

David B Meyer et al. J Am Assoc Nurse Pract. .

Abstract

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is emerging in prevalence with an increasingly aging population. The complex nature of the disease and its association with significant morbidity and mortality has resulted in a call for a new integrative, multidisciplinary approach to AF management.

Purpose: Determine if the use of a nurse practitioner (NP)-led AF clinic (NPAFC) can improve care for patients.

Methodology: An NPAFC was designed to serve as an independent clinic for standardizing patient care and improving access to care. Baseline patient demographics, care pathway, and interventions were characterized in clinic. Primary outcomes were hospitalizations and emergency department (ER) visits, before and after clinic implementation.

Results: Overall, 1,442 patients were enrolled in the AF clinic between January 2016 and June 2018. The mean age at the first AF clinic visit was 68.7 ± 12.6 years, 54% were male, and the mean body mass index was 31 ± 7 kg/m2. Among the patients, 45.2% had paroxysmal AF, 43.6% persistent AF, and 5.5% permanent AF. With an average of 3 ± 3 clinic visits per patient, the number of patients with ≥1 hospitalization decreased by 78% after clinic implementation. Similarly, the number of patients with ≥1 ER visit decreased by 79%, and 22.7% of patients avoided at least one ER visit.

Conclusions: The number of patients with ≥1 hospitalization or ≥1ER visit decreased within two years after the implementation of an NPAFC.

Implications: Implementation of an NP-led AF clinic in the United States may reduce hospitalizations and ER visits if implemented in an integrative model.

PubMed Disclaimer

References

    1. Abadie B., Hansen B., Walker J., Deyo Z., Biese K., Armbruster T., Sears S. F., Tuttle H., Sadaf M. I., Gehi A. K. (2020). An atrial fibrillation transitions of care clinic improves atrial fibrillation quality metrics. J Am Coll Cardiol EP. 6(1), 45–52. https://doi.org/10.1016/j.jacep.2019.09.001 - DOI
    1. Abed H. S., Wittert G. A., Leong D. P., Shirazi M. G., Bahrami B., Midddeldorp M. E., Lorimer M. F., Lau D. H., Antic N. A., Brooks A. G., Abhayaratna W. P., Kalman J. M., Sanders P. (2013). Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: A randomized clinical trial. JAMA, 310(19), 2050–2060. https://doi.org/10.1001/jama.2013.280521 - DOI
    1. Benjamin E. J., Levy D., Vaziri S. M., D'Agostino R. B., Belanger A. J., Wolf P. A. (1994). Independent risk factors for atrial fibrillation in a population-based cohort: The framingham heart study. JAMA, 271(11), 840–844.
    1. Bunch T. J., May H. T., Bair T. L., Johnson D. L., Weiss J. P., Crandall B. G., Osborn J. S., Anderson J. L., Muhlestein J. B., Lappe D. L., Day J. D. (2013). Increasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long-term outcomes. Heart Rhythm, 10(9), 1257–1262. https://doi.org/10.1016/j.hrthm.2013.05.013 - DOI
    1. Calkins H., Hindricks G., Cappato R., Kim Y.-H., Saad E. B., Aguinaga L., Akar J. G., Badhwar V., Brugada J., Camm J., Chen P.-S., Chen S.-A., Chung M. K., Nielsen J. C., Curtis A. B., Davies D. W., Day J. D., d'Avila A., de Groot N. M. S., Yamane T. (2017). 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm, 14(10), e275-e444. https://doi.org/10.1016/j.hrthm.2017.05.012 - DOI