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A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation

Author

Listed:
  • Brigitte Fong Yeong Woo

    (Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore)

  • Wilson Wai San Tam

    (Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore)

  • Taiju Rangpa

    (Bukit Batok—Medical, National University Polyclinics, National University Health System, Singapore 659164, Singapore)

  • Wei Fong Liau

    (Bukit Batok—Nursing, National University Polyclinics, National University Health System, Singapore 659164, Singapore)

  • Jennifer Nathania

    (Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore)

  • Toon Wei Lim

    (Department of Cardiology, National University Heart Centre, National University Health System, Singapore 119228, Singapore)

Abstract

The current physician-centric model of care is not sustainable for the rising tide of atrial fibrillation. The integrated model of care has been recommended for managing atrial fibrillation. This study aims to provide a preliminary evaluation of the effectiveness of a Nurse-led Integrated Chronic care E-enhanced Atrial Fibrillation (NICE-AF) clinic in the community. The NICE-AF clinic was led by an advanced practice nurse (APN) who collaborated with a family physician. The clinic embodied integrated care and shifted from hospital-based, physician-centric care. Regular patient education, supplemented by a specially curated webpage, fast-tracked appointments for hospital-based specialised investigations, and teleconsultation with a hospital-based cardiologist were the highlights of the clinic. Forty-three participants were included in the six-month preliminary evaluation. No significant differences were observed in cardiovascular hospitalisations ( p -value = 0.102) and stroke incidence ( p -value = 1.00) after attending the NICE-AF clinic. However, significant improvements were noted for AF-specific QoL ( p = 0.001), AF knowledge ( p < 0.001), medication adherence ( p = 0.008), patient satisfaction ( p = 0.020), and depression ( p = 0004). The preliminary evaluation of the NICE-AF clinic demonstrated the clinical utility of this new model of integrated care in providing safe and effective community-based AF care. Although a full evaluation is pending, the preliminary results highlighted its promising potential to be expanded into a permanent, larger-scale service.

Suggested Citation

  • Brigitte Fong Yeong Woo & Wilson Wai San Tam & Taiju Rangpa & Wei Fong Liau & Jennifer Nathania & Toon Wei Lim, 2022. "A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation," IJERPH, MDPI, vol. 19(8), pages 1-15, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:8:p:4467-:d:789133
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    References listed on IDEAS

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    1. Vivi Skibdal Frydensberg & Axel Brandes, 2018. "Does an interdisciplinary outpatient atrial fibrillation (AF) clinic affect the number of acute AF admissions? A retrospective cohort study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(13-14), pages 2684-2690, July.
    2. Bernard Rosner & Robert J. Glynn & Mei-Ling T. Lee, 2006. "The Wilcoxon Signed Rank Test for Paired Comparisons of Clustered Data," Biometrics, The International Biometric Society, vol. 62(1), pages 185-192, March.
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    1. Kathy L. Rush & Lindsay Burton & Cherisse L. Seaton & Peter Loewen & Brian P. O’Connor & Kendra Corman & Robyn Phillips & Lana Moroz & Jason G. Andrade, 2023. "Usability and Feasibility Testing of an Atrial Fibrillation Educational Website with Patients Referred to an Atrial Fibrillation Specialty Clinic," IJERPH, MDPI, vol. 20(18), pages 1-16, September.

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