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Guideline adherence is remarkably poor among patients with atrial fibrillation (AF), an objective assessment of the STEEER-AF trial determined. Fortunately, a short online intervention for healthcare professionals was able to increase patient adherence to rhythm control recommendations.

“Although we know that adherence to guidelines and patient education improve outcomes in patients with AF, we do not have solid evidence regarding the actual adherence to ESC guidelines,” outlined Prof. Dipak Kotecha, MRCP, MBChB, PhD, from the University of Birmingham, in UK¹. The STEEER-AF trial (NCT04396418) assessed guideline adherence and tested an educational intervention to improve guideline adherence.

The investigators measured the adherence to class I and class III recommendations for stroke prevention and rhythm control among 1,732 patients with AF from France, Germany, Italy, Poland, Spain and the UK. Additionally, 70 treatment centers were randomly assigned 1:1 to an intervention group or a usual-care group. In the intervention group, the responsible healthcare professionals followed an online educational program on improving patient adherence in the AF population.

Baseline adherence to all relevant class I and III ESC guideline recommendations were low for stroke prevention (61.0%) and abysmal for rhythm control (21.0%). On the bright side, the intervention was associated with a 51% increase in adherence to rhythm control guideline recommendations (21.4% to 33.9%), significantly outperforming the control arm (20.5% to 22.9%). For stroke prevention, the corresponding results in the intervention arm were 63.4% at baseline to 67.5% at follow-up; in the control arm, the adherence rate went from 58.6% to 60.9%. The difference between the two study arms did not reach statistical significance.

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