Professor Hendriks’ iCARE project shows that nurses in AF clinics can lead the way in care delivery, but emphasises that patients can’t just have passive acceptance of a doctor’s treatment; there is a need for patients to be onboard with changing and adapting their own lifestyle to assist the process and make it truly effective.
“It’s a big task. Most people have little idea about AF until they have an episode, so the iCARE clinics serve as a crucial resource to guide them. This model has proven that people are receptive and do want to learn more about AF, and to be successful the care package has to be as tailored to the individual as possible.”
Success with the initial iCARE trial has stimulated plans and funding applications to expand these clinics to other centres.
“The response from patients has reinforced my original hopes – that empowering the patients with more knowledge about AF is the first building block towards more efficient care delivery,” says Professor Hendriks. “It means they will only come back to hospitals in emergency situations, which is so important because the pressure that a growing number of AF patients will put on our hospital system is going to be enormous.”
He says an increased use of new technology also plays a key role, with decision-support technology, based on international guideline recommendations, guiding the clinical team through the care process. An educational booklet is available for patients, that provides information on AF, its symptoms and treatment, as well as risk factors and how to modify their lifestyle. They can also input incidents of AF and any other symptoms they are experiencing, which can help guide the iCARE-AF team in making treatment decisions.
“This suggests where we could do more – looking deeper into how digital technology can support patients and healthcare professionals.”
Professor Hendriks has been inspired by work done during COVID lockdowns with colleagues at Maastricht University in the Netherlands to perform remote monitoring of patients with AF by having patients put their finger over their mobile phone camera lens, enabling an app with PPG (photoplethysmography) software read their heart rate and rhythm. They had readings uploaded three times each day for a week to a cloud storage facility, giving doctors and nurses effective monitoring of these patients before teleconsultation appointments.
“It’s a simple intervention, but so effective – and now we are seeing hospitals across Europe embedding this in their daily practice. We found that patients were very conscientious about taking these readings and it was best used by older patients, which dispels thoughts that older people have resistance to using technology.”
While this represents a valuable new tool within a suite of measures to monitor AF, there is no magic bullet to cure the disease – which is why in another part of Flinders University, an electrophysiology team is exploring new ways of predicting outcomes of AF through an objective, biophysics-based approach to mapping and treatment.