AF-GEN-UK: UK extension of Long-term Registry of Atrial Fibrillation

  • Research type

    Research Study

  • Full title

    Long-term Registry of Patients with Atrial Fibrillation UK Extension (AF-GEN-UK) Study

  • IRAS ID

    183028

  • Contact name

    Sean Jennings

  • Contact email

    researchgovernance@contacts.bham.ac.uk

  • Sponsor organisation

    University of Birmingham

  • Duration of Study in the UK

    2 years, 6 months, 1 days

  • Research summary

    Summary of Research

    Given the advances in the management of atrial fibrillation (an irregular heart rhythm), especially the new medications for stroke prevention, and the availability of new European Society of Cardiology (ESC) clinical guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of atrial fibrillation. There is currently a registry collecting data on how cardiologists (specialists in conditions of the heart) manage and treat patients with atrial fibrillation in 55 countries in Europe. Data is being collected on how cardiologists in the UK manage patients with atrial fibrillation. However, in the UK, patients with atrial fibrillation are also managed by other doctors, particularly their general practitioner (GPs), accident and emergency (A&E) doctors (when admitted to hospital), stroke doctors (when atrial fibrillation is diagnosed after a stroke has occurred) and by acute medicine doctors (as atrial fibrillation is more common among people aged 65 years and older). This study will allow us to compare how patients with atrial fibrillation are managed by heart specialists (cardiologists) and other doctors (non-heart specialists). The purpose of collecting this data is to see if atrial fibrillation patients are managed in line with clinical guidelines. In this UK extension study we will recruit up to 1650 atrial fibrillation managed by GPs, cardiologists, A&E, stroke, and acute medicine doctors. Demographic (e.g. age, sex, ethnicity etc.) and clinical (e.g. other health problems, medications, operations etc.) information will be recorded at baseline and then the patient will be followed up 12 months later to see how their healthcare is managed over time. The follow-up will involve the patient visiting the hospital and/or review of their medical records and/or telephone call with the patient or their GP, according to the usual practice of the medical specialty who is managing the patient.

    Summary of Results

    The purpose of this study was to gather information about people in the United Kingdom with an irregular heart rhythm, called atrial fibrillation, and to look at how their healthcare is managed by doctors. We wanted to see if there were any differences in how people with atrial fibrillation are managed by different types of doctors and if guidelines on how to treat them are followed. We were particularly interested in how many people were prescribed a medication to reduce their risk of stroke (called oral anticoagulation). We were also interested to see if there were any differences in how people with symptoms were managed compared to those without symptoms. We looked at patients managed by cardiologists (heart specialists), general practitioners, stroke doctors, and emergency and acute medicine doctors. We collected information about patients including their age, sex, ethnicity, medical history, medications, any procedures or interventions they received, and recorded this anonymously in a registry (a confidential database). We followed up people over a one year period to see how many people had a stroke, were hospitalised, or died. We also measured quality of life using a short questionnaire. We included 1595 people with atrial fibrillation, 60% were men, 97% were white and the average age was 71 years. Eighty-four percent of people were prescribed an oral anticoagulant drug to reduce their risk of stroke at the start of the data collection and this increased to 87% at 1-year follow-up. GPs were more likely to prescribe warfarin than one of the newer types of oral anticoagulant drugs than doctors that worked in hospitals (cardiologists, stroke doctors, A&E, and acute medicine doctors). Fifty-seven percent of people with atrial fibrillation reported that they had symptoms and these symptoms were severe in 18%. Patients with symptoms were mainly cared for by cardiologists or emergency/acute medicine doctors in hospital. Most patients reported a good quality of life but those with symptoms had slightly poorer quality of life compared to those without symptoms. This study collected important up-to-date information on a large group of people with atrial fibrillation in the UK and recorded how they are managed by different medical doctors. Overall most patients received care that was consistent with ‘best practice’, with 87% of people of atrial fibrillation receiving medication to reduce their risk of stroke.

  • REC name

    West Midlands - South Birmingham Research Ethics Committee

  • REC reference

    17/WM/0013

  • Date of REC Opinion

    25 Jan 2017

  • REC opinion

    Favourable Opinion