Upskilling and supporting rural doctors led to a 36% lower risk for adverse cardiovascular outcomes over 3 years among older individuals with atrial fibrillation.
LONDON — An integrated care model that uses telemedicine to educate and link doctors working in a rural area of China with atrial fibrillation specialists in urban hospitals has resulted in greater adherence to guideline-recommended care and significantly improved overall patient outcomes.
Results of the MIRACLE-AF study showed that 33.1% of the patients in the intervention group vs 8.7% of those in the usual care group met the criteria of the atrial fibrillation better care pathway at 1 year. The primary outcome of the trial was a composite of cardiovascular death, all stroke types, hospitalization due to worsening of heart failure or acute coronary syndrome , and emergency hospital visits for AF. The trial found that the patients in the intervention group were 36% less likely to meet this primary outcome at 3 years compared with the control group.=.025). There was a trend towards fewer emergency hospital visits for AF and no increase in the risk for major bleeding.
"It touches upon the theme of our age — healthcare equity and global health. It is not only in China that we have very big, very old populations in the rural areas. Other low- and middle-income countries also have the rural areas, the mountainous areas, and remote areas," he said.
AF Afib A-Fib Afib Afib Atrial Fib Atrial Fibrillation (AF) Atrial Fibrillation (A-Fib) AF - Atrial Fibrillation Rural Health Rural Medicine Rural Interprofessional Interprofessional Collaboration Interprofessional Team Health Care Team Team-Based Care Teamwork Collaborative Practice Interprofessional Education Interprofessional Continuing Education
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