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Article: Nurse-Led Multicomponent Behavioral Activation Intervention for Patients With Atrial Fibrillation: A Randomized Controlled Trial

TitleNurse-Led Multicomponent Behavioral Activation Intervention for Patients With Atrial Fibrillation: A Randomized Controlled Trial
Authors
Li, Polly WCYu, Doris SFYan, Bryan P
Keywordsatrial fibrillation
decision making
empowerment
nurse's role
patient education
patient participation
self-management
shared
Issue Date1-Jan-2025
PublisherLippincott, Williams & Wilkins
Citation
Circulation: Arrhythmia and Electrophysiology, 2025, v. 18, n. 1, p. e013236 How to Cite?
DOI: http://dx.doi.org/10.1161/CIRCEP.124.013236
Abstract

BACKGROUND:

Patients with atrial fibrillation (AF) are often ill-equipped for shared decision-making. This study investigated the effects of a patient empowerment care model on patient-reported health outcomes and treatment decision-making in patients with AF.

METHODS:

This randomized controlled trial prospectively randomized patients with AF to receive standard care (n=194) or a 13-week nurse-led multicomponent behavioral activation intervention (n=198). The intervention consisted of risk profile assessments, empowered shared decision-making regarding the use of oral anticoagulants (OACs), empowered AF self-management, and increased access to professional advice. The primary outcome was health-related quality of life measured after the completion of the intervention (T1), while the secondary outcomes were patient-physician decision concordance regarding OAC use, actual OAC use, AF knowledge, medication adherence, anxiety, and depression.

RESULTS:

The intervention group showed significantly greater improvements in health-related quality of life (β, −6.702 [95% CI, −9.556 to −3.847]; P<0.001), AF knowledge (β, −1.989 [95% CI, −2.342 to −1.635]; P<0.001), and medication adherence (β, 0.340 [95% CI, 0.148–0.532]; P<0.001) at immediate post-intervention compared with the control group, and the improvements were sustained at 6 months for all outcomes. A higher proportion of patients in the intervention group were prescribed an OAC compared with the control group at 6 months (odds ratio, 5.870 [95% CI, 1.957–12.331]; P=0.012). No significant between-group differences were detected for patient-physician decision concordance regarding OAC use, anxiety, or depression at both time points.

CONCLUSIONS:

The nurse-led multicomponent behavioral activation intervention improved patient-reported outcomes and increased OAC prescription among patients with AF.


Persistent Identifierhttp://hdl.handle.net/10722/358811
ISSN
1941-3149
2023 Impact Factor: 9.1
2023 SCImago Journal Rankings: 3.335

 

DC FieldValueLanguage
dc.contributor.authorLi, Polly WC-
dc.contributor.authorYu, Doris SF-
dc.contributor.authorYan, Bryan P-
dc.date.accessioned2025-08-13T07:48:11Z-
dc.date.available2025-08-13T07:48:11Z-
dc.date.issued2025-01-01-
dc.identifier.citationCirculation: Arrhythmia and Electrophysiology, 2025, v. 18, n. 1, p. e013236-
dc.identifier.issn1941-3149-
dc.identifier.urihttp://hdl.handle.net/10722/358811-
dc.description.abstract<h3>BACKGROUND:</h3><p>Patients with atrial fibrillation (AF) are often ill-equipped for shared decision-making. This study investigated the effects of a patient empowerment care model on patient-reported health outcomes and treatment decision-making in patients with AF.</p><h3>METHODS:</h3><p>This randomized controlled trial prospectively randomized patients with AF to receive standard care (n=194) or a 13-week nurse-led multicomponent behavioral activation intervention (n=198). The intervention consisted of risk profile assessments, empowered shared decision-making regarding the use of oral anticoagulants (OACs), empowered AF self-management, and increased access to professional advice. The primary outcome was health-related quality of life measured after the completion of the intervention (T1), while the secondary outcomes were patient-physician decision concordance regarding OAC use, actual OAC use, AF knowledge, medication adherence, anxiety, and depression.</p><h3>RESULTS:</h3><p>The intervention group showed significantly greater improvements in health-related quality of life (β, −6.702 [95% CI, −9.556 to −3.847]; <em>P</em><0.001), AF knowledge (β, −1.989 [95% CI, −2.342 to −1.635]; <em>P</em><0.001), and medication adherence (β, 0.340 [95% CI, 0.148–0.532]; <em>P</em><0.001) at immediate post-intervention compared with the control group, and the improvements were sustained at 6 months for all outcomes. A higher proportion of patients in the intervention group were prescribed an OAC compared with the control group at 6 months (odds ratio, 5.870 [95% CI, 1.957–12.331]; <em>P</em>=0.012). No significant between-group differences were detected for patient-physician decision concordance regarding OAC use, anxiety, or depression at both time points.</p><h3>CONCLUSIONS:</h3><p>The nurse-led multicomponent behavioral activation intervention improved patient-reported outcomes and increased OAC prescription among patients with AF.</p>-
dc.languageeng-
dc.publisherLippincott, Williams & Wilkins-
dc.relation.ispartofCirculation: Arrhythmia and Electrophysiology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectatrial fibrillation-
dc.subjectdecision making-
dc.subjectempowerment-
dc.subjectnurse's role-
dc.subjectpatient education-
dc.subjectpatient participation-
dc.subjectself-management-
dc.subjectshared-
dc.titleNurse-Led Multicomponent Behavioral Activation Intervention for Patients With Atrial Fibrillation: A Randomized Controlled Trial-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1161/CIRCEP.124.013236-
dc.identifier.scopuseid_2-s2.0-85212922565-
dc.identifier.volume18-
dc.identifier.issue1-
dc.identifier.spagee013236-
dc.identifier.eissn1941-3084-
dc.identifier.issnl1941-3084-

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