{"title":"初级卫生保健中护士主导的房颤诊所：证据综述。","authors":"Maria Dahlberg, Ulf Jakobsson","doi":"10.1080/02813432.2025.2466175","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects.</p><p><strong>Aim: </strong>To review the scientific literature regarding the effects of nurse-led AF clinics in PHC.</p><p><strong>Methods: </strong>A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles.</p><p><strong>Results: </strong>Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments.</p><p><strong>Conclusions: </strong>Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"510-514"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090316/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nurse-led atrial fibrillation clinics in primary health care: a review of the evidence.\",\"authors\":\"Maria Dahlberg, Ulf Jakobsson\",\"doi\":\"10.1080/02813432.2025.2466175\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects.</p><p><strong>Aim: </strong>To review the scientific literature regarding the effects of nurse-led AF clinics in PHC.</p><p><strong>Methods: </strong>A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles.</p><p><strong>Results: </strong>Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments.</p><p><strong>Conclusions: </strong>Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.</p>\",\"PeriodicalId\":21521,\"journal\":{\"name\":\"Scandinavian Journal of Primary Health Care\",\"volume\":\" \",\"pages\":\"510-514\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090316/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Journal of Primary Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02813432.2025.2466175\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Primary Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02813432.2025.2466175","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Nurse-led atrial fibrillation clinics in primary health care: a review of the evidence.
Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects.
Aim: To review the scientific literature regarding the effects of nurse-led AF clinics in PHC.
Methods: A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles.
Results: Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments.
Conclusions: Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.
期刊介绍：
Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice.
Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include:
• Clinical family medicine
• Epidemiological research
• Qualitative research
• Health services research.
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