PS2-35: Adaptation of a Disease-Specific Research Instrument for Quality of Life Assessments in Emergency Department Patients with Atrial Fibrillation/Flutter

Abstract

Background: The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a novel disease-specific quality-of-life (QoL) instrument for patients with atrial fibrillation/flutter (AF/F). The AFEQT questionnaire, which evaluates a patient's perception of his or her AF/F symptoms, physical function, and emotional health, can serve as a marker of quality of care. To date, there are no reports of its practical performance. Objectives: We describe the feasibility of simplifying the AFEQT for short-term QoL assessments via phone within a diverse population of AF/F patients receiving emergency department (ED) care across seven community hospitals. Methods: As part of a multicenter observational study of ED management and short-term outcomes of AF/F patients, we adapted the AFEQT for phone follow-up with patients one month after their ED visits for newly diagnosed or recent-onset (<48 hours) AF/F. We kept the original 20-item AFEQT format, but condensed the seven-point Likert response scale to five for ease of interviewing. We added questions about health in weeks prior to the ED visit, effectiveness of ED treatment, and medication compliance. Patients were consented for participation by phone and excluded if: unable to discriminate between AF/F and other comorbidities; unable to recall diagnosis; too ill to talk; deceased; non-English speaking. Results: Among 1539 patients with newly diagnosed or recent-onset AF/F, 1157 (75%) were eligible for an interview. Of these, 986 (85%) were interviewed. Thirty-four (3%) refused to participate; 93 (8%) were lost to follow-up. Reasons for refusal included discomfort with discussing health and informed choice not to participate in research. The average time per call in a sample of 483 patients was 10.5 minutes (IQR 4). From the 986 interviews completed, there are 932 unique survey respondents whose characteristics are shown in the table. Their mean age is 69 years (IQR 19). Conclusion: These interim results suggest that our modified AFEQT is a practical and feasible research tool for QoL assessments within a diverse subpopulation of AF/F patients. Additional analyses will evaluate the association between QoL scores and patient and treatment factors. Future investigations utilizing this and other disease-specific tools may consider modifications, such as adaptation to phone interview, to better match the instrument to the study population and survey modality. (Figure Presented).