Atrial fibrillation and primary care prevention and rehabilitation – a feasibility study

Background: The increasing prevalence of atrial fibrillation (AF) poses a global healthcare challenge, necessitating effective management strategies. AF is associated with reduced health-related quality of life (HRQoL), higher mental distress, and frequent hospital readmissions. Interventions like patient education and physical exercise have shown promise in reducing these burdens, yet their integration into primary care in a complex intervention set-up lacks thorough qualification and evidence. Aim: This study aimed to investigate the feasibility of delivering a comprehensive prevention and rehabilitation intervention for individuals with AF in a primary Healthcare Center. Secondary objectives explored participant experiences and acceptability, needs and preferences, and changes in HRQoL, anxiety, and depression as well as feasibility of collecting patient-reported outcome measures (PROMs). Trial design: A single-arm, intervention, feasibility study was conducted. Methods: The primary feasibility outcomes were to investigate acceptability among participants and impact on the key outcomes HRQoL, anxiety and depression. Participants were consecutively recruited from a university hospital outpatient AF-clinic and referred to a primary Healthcare Center. The complex intervention included patient education, physical exercise, Medicinal yoga, psychosocial support and risk factor management. Quantitative data were collected using PROMs for HRQoL, anxiety and depression, while qualitative data were obtained through focus group interviews and field notes. Data analysis involved descriptive statistics and thematic analysis in a mixed-methods evaluation. Results: Of the 50 participants enrolled, 43 (86%) completed the intervention. The complex intervention was feasible in a primary Healthcare Center with high acceptability. HRQoL improved from baseline to end-intervention and maintained at two-month follow-up, and symptoms of anxiety and depression decreased. Qualitative findings highlighted the importance of support from healthcare professionals and peers, alongside increased knowledge and tools to manage AF symptoms. Harms: No adverse events were reported. Conclusions: The study demonstrated the feasibility of a complex prevention and rehabilitation intervention for individuals with AF in a primary care setting and valuable insights were gained into the potential effectiveness and acceptability of the intervention. These findings underscore the importance of implementing comprehensive AF management programs and warrant further evaluation through large-scale randomized controlled trials. Trial registration: ClinicalTrials Identifier: NCT06337045.