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Identifying rehabilitation needs as part of secondary prevention in individuals with Atrial Fibrillation - a Delphi consensus study

  • Caroline M Elnegaard
  • , Signe S Risom
  • , Britt Borregaard
  • , Mickael Bech
  • , Ditte Albrektsen
  • , Jan Astrup
  • , Ann Bovin
  • , Bo Christensen
  • , Jonathan David
  • , Lien Desteghe
  • , Jeff S Healey
  • , Jeroen M Hendriks
  • , Jelle C L Himmelreich
  • , Albert M Joensen
  • , Ioannis Katsoularis
  • , Deirdre A Lane
  • , Gregory Y H Lip
  • , Thomas Maribo
  • , Lis Neubeck
  • , Linda Ottoboni
  • Maria Pedersen, Stine Maria Rosenstroem, Anne Merete Boas Soja, Emma Svennberg, Line Vilholm, Kathryn Wood, Matthias Daniel Zink, Ann-Dorthe Zwisler, Axel Brandes
  • Odense University Hospital
  • Department of Cardiology, Roskilde Hospital
  • Dietetics and Clinical Nutrition Research Unit, Herlev and Gentofte University Hospital, Herlev
  • University of Copenhagen
  • University of Southern Denmark
  • Tarup Ungdomsskole, Odense Kommune
  • Vejle Sygehus, Sygehus Lillebælt
  • Aarhus University
  • Stanford Health Care
  • Antwerp University Hospital, Antwerp, Belgium
  • Population Health Research Institute
  • University of Amsterdam
  • Hjørring Sygehus
  • Umeå University
  • University of Liverpool
  • Edinburgh Napier University
  • Copenhagen University Hospital
  • Holbæk Sygehus
  • Karolinska University Hospital
  • 1 Queen Ingrid Primary Healthcare Center
  • Emory University, School of Law
  • Albert-Ludwigs-University Freiburg
  • Syddansk Universitetshospital

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

AIM: This study aimed to establish general consensus on a systematic needs assessment model to determine eligibility for cardiac rehabilitation (CR) as part of secondary prevention in individuals with atrial fibrillation (AF). Specific objectives included identifying relevant needs assessment criteria and establishing consensus on referral criteria.

METHODS: A Delphi study was conducted following the ACCORD guidelines (ACcurate COnsensus Reporting Document) with participation of an international, multi-disciplinary expert panel including physicians, nurses and other healthcare professionals, across primary and secondary care as well as academic research. The panel also included six people who had AF themselves. The Delphi process involved three iterative rounds of surveys and a video meeting to determine needs assessment criteria and facilitate consensus. Data collection included qualitative feedback and quantitative voting on proposed criteria.

RESULTS: Sixty-nine experts participated. There was high agreement on the importance of the study, which identified 12 needs assessment criteria related to AF symptom burden, health-related quality of life, anxiety, medicine adherence, and various risk factors. Whilst there was agreement on the needs assessment model, experts noted that referral criteria should be flexible and tailored to local healthcare settings, emphasizing that each individual's situation is unique.

CONCLUSION: This Delphi study established a needs assessment model that can be adapted to local contexts for individuals with AF. More research is needed to refine referral criteria and ensure effective implementation of individually tailored CR strategies.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
ISSN2047-4873
DOIs
Publication statusE-pub ahead of print - 9 Sept 2025

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