Please use this identifier to cite or link to this item: https://doi.org/10.3390/ijerph19084467
Title: A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation
Authors: Guo, Huiling 
Hildon, Zoe Jane-Lara 
Loh, Victor Weng Keong
Sundram, Meena
Bin Ibrahim, Muhamad Alif
Tang, Wern Ee
Chow, Angela 
Keywords: Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Public, Environmental & Occupational Health
Environmental Sciences & Ecology
atrial fibrillation
nurse-led
integrated care
advanced practice nurse
QUALITY-OF-LIFE
DEPRESSION
MANAGEMENT
ADHERENCE
IMPROVE
ANXIETY
TRIAL
Issue Date: 1-Apr-2022
Publisher: MDPI
Citation: Guo, Huiling, Hildon, Zoe Jane-Lara, Loh, Victor Weng Keong, Sundram, Meena, Bin Ibrahim, Muhamad Alif, Tang, Wern Ee, Chow, Angela (2022-04-01). A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 19 (8). ScholarBank@NUS Repository. https://doi.org/10.3390/ijerph19084467
Abstract: The current physician-centric model of care is not sustainable for the rising tide of atrial fibrillation. The integrated model of care has been recommended for managing atrial fibrillation. This study aims to provide a preliminary evaluation of the effectiveness of a Nurse-led Integrated Chronic care E-enhanced Atrial Fibrillation (NICE-AF) clinic in the community. The NICE-AF clinic was led by an advanced practice nurse (APN) who collaborated with a family physician. The clinic embodied integrated care and shifted from hospital-based, physician-centric care. Regular patient education, supplemented by a specially curated webpage, fast-tracked appointments for hospital-based specialised investigations, and teleconsultation with a hospital-based cardiologist were the highlights of the clinic. Forty-three participants were included in the six-month preliminary evaluation. No significant differences were observed in cardiovascular hospitalisations (p-value = 0.102) and stroke incidence (p-value = 1.00) after attending the NICE-AF clinic. However, significant improvements were noted for AF-specific QoL (p = 0.001), AF knowledge (p < 0.001), medication adherence (p = 0.008), patient satisfaction (p = 0.020), and depression (p = 0004). The preliminary evaluation of the NICE-AF clinic demonstrated the clinical utility of this new model of integrated care in providing safe and effective community-based AF care. Although a full evaluation is pending, the preliminary results highlighted its promising potential to be expanded into a permanent, larger-scale service.
Source Title: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
URI: https://scholarbank.nus.edu.sg/handle/10635/228517
ISSN: 1661-7827
1660-4601
DOI: 10.3390/ijerph19084467
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