P817Effect of individualised education sessions on the knowledge level of patients with atrial fibrillation

Abstract

Background: Education of patients with atrial fibrillation (AF) is a key factor in their management. Good knowledge of the patient about his/her arrhythmia and its therapy allows active patient involvement during shared decision making. This can lead to better quality of life, good adherence to the prescribed medication and better outcomes. However, the best strategy to provide education is not known. Purpose: The aim of this study was to investigate the effect of targeted individualised education on the knowledge level of AF patients. Methods: A prospective randomised controlled trial was set up to evaluate the effect of individualised education using the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ). The validated JAKQ contains 8 questions about AF in general, 5 questions about oral anticoagulation therapy and either 3 questions about vitamin K antagonists or non-vitamin K antagonist oral anticoagulants. A total of 67 hospitalised or ambulatory AF patients were included in this study with follow-up visits after 1, 3 and 6 months. During each visit, they had to complete the JAKQ. At baseline, patients were randomised to an intervention group or a control group. At each visit, the intervention group received individualised, tailored education focused on the knowledge gaps revealed by the JAKQ. The control group filled out the JAKQ and received standard care without additional educational efforts. Results: The follow-up visits were completed in 63 patients (i.e. drop-out of 6.0%) of whom 31 were assigned to the intervention group and 32 to the control group. Patients had a mean age of 72±8 years and 63.5% were male. The completion of the JAKQ took on average 6.8±2.9 min during the entire study period (n=63). Providing tailored education after JAKQ completion in the intervention group required an extra 8.5±4.9 min at baseline, 8.5±6.0 min after 1 month and 6.2±3.0 min after three months (n=31). Both groups had similar scores at the start of the study, i.e. 58.5±15.9% for the intervention group and 59.2±18.8% for the control group (p=0.872). The intervention group scored significantly better on the JAKQ over time (77.2±13.3% after one month, 84.3±13.1% after 3 months and 85.5±13.9% after 6 months, p<0.001). However, there was no improvement in the control group with a score of 61.1±19.9% after 1 month, 63.9±19.9% after 3 months and 58.6±21.8% after 6 months (p=0.222). Conclusions: The JAKQ is an effective and feasible tool to provide individualised education for AF patients. After a single directed educational session based on completion of the JAKQ, the knowledge level of AF patients could be significantly improved. Additional educational sessions maintained this improved knowledge level.