Atrial Fibrillation Clinical Trial
Official title:
IntegRAted Chronic Care Program at a Specialized Atrial Fibrillation (AF) Clinic Versus Usual CarE in Patients With Atrial Fibrillation, an Investigator-initiated, Prospective, Randomised, Open Label, Blinded Outcome Assessment (PROBE) Controlled Multi-center Study
Rationale: The treatment of patients with atrial fibrillation is often inadequate due to poor
guideline adherence. An integrated chronic care program (ICCP) at a specialized AF-clinic was
found to be superior to usual care provided by a cardiologist in terms of cardiovascular
hospitalizations and cardiovascular mortality.
Hypothesis: treatment at a specialized AF clinic is superior to usual care in terms of
cardiovascular mortality and cardiovascular hospitalizations, cost-effectiveness, quality of
life and guideline adherence.
Objectives: primary objective is to show that an ICCP reduces cardiovascular hospitalizations
and mortality.
Study design: randomized controlled trial with two study arms: usual care provided by
cardiologists (control) versus integrated chronic care program at a specialized AF clinic
(intervention) in 8 hospitals in the Netherlands. The RACE4 is an event driven study. A total
number of 246 events is needed. In total 1716 patients with newly diagnosed AF will be
included. Total duration of the study is 5 years and 10 months with a minimal follow up of 1
year. Data is collected at inclusion, after 3, 6, 12 months, every year thereafter and at the
end of the study.
Study population: Patients older than 18 year with newly diagnosed AF.
Intervention: The intervention is delivered through the specialized outpatient AF clinic. The
multidisciplinary team at the AF clinic consists of a nurse practitioner or physician
assistant or specialised cardiovascular nurse, cardiologist, and is guided by
guidelines-based decision support software program based on the applicable ESC guideline
recommendations. The use of a web-based patient centered management of patient's own
medication (Medication manager TM) was optional. A standardized diagnostic, treatment and
follow-up pathway was performed within the ICCP.
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