The effects of a nurse-led, person-centred outpatient clinic on patient-reported outcomes in patients with atrial fibrillation: a randomized controlled trial

AIMS: To evaluate the effects of a nurse-led, person-centred outpatient clinic on patient-reported outcomes in patients with atrial fibrillation (AF). METHODS AND RESULTS: In this open-label, parallel randomized controlled trial, 140 patients with AF were randomly assigned. The intervention group met experienced cardiac nurses, trained in person-centred care and AF. The control group met a physician in accordance with usual care. At baseline, and after 6 months, patients completed questionnaires: The EuroQol five-dimension three-level questionnaire (EQ-5D-3L), the EuroQol Visual Analogue Scale, the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA), the Brief Illness Perception Questionnaire (B-IPQ), and the Hospital Anxiety and Depression Scale. Over time, health-related quality of life (HRQoL), as measured by the EQ-5D index and the ASTA mental subscale, improved in the intervention group (P = 0.035 and P = 0.014, respectively) and the control group (P = 0.031 and P = 0.026, respectively). Illness coherence (B-IPQ) also improved in both groups (P < 0.001 and P = 0.012, respectively). In the nurse-led group, HRQoL as measured by the ASTA total scale (P = 0.035) and personal control (B-IPQ) (P = 0.005) improved, while illness-related concerns (P = 0.008) and emotional representations (B-IPQ) (P = 0.001) decreased. There were no significant between-group differences on any of the analysed measurement instruments. CONCLUSION: No significant differences were observed between groups. However, improvements in HRQoL and illness coherence in both groups suggest that receiving support from nurses and physicians may improve these outcomes. Furthermore, the results suggest that a nurse-led, person-centred outpatient clinic may reduce patients' emotional responses and concerns related to the illness, while strengthening their sense of personal control. REGISTRATION: ClinicalTrials.gov ID: NCT04609202.