Evidence map›Paper›PMID 35486435›Full record

ArticleJMIR formative research2022

Adherence to a Multidisciplinary Lifestyle Program for Patients With Atrial Fibrillation and Obesity: Feasibility Study.

Nicole Tenbult, Jos Kraal, Rutger Brouwers, Ruud Spee, Sabine Eijsbouts, Hareld Kemps

Open access · goldAbstract read
In one paragraph

Article in JMIR formative research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Adherence to Behavioral Weight Management: A Scoping Review of Definitions, Measurement, and Components.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Nicole Tenbult *Telemedicine and Rehabilitation in Chronic Disease, Flow, Center for Prevention, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0002-9021-9895
Jos KraalTelemedicine and Rehabilitation in Chronic Disease, Flow, Center for Prevention, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0001-9667-6926
Rutger BrouwersTelemedicine and Rehabilitation in Chronic Disease, Flow, Center for Prevention, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0002-8409-2357
Ruud SpeeTelemedicine and Rehabilitation in Chronic Disease, Flow, Center for Prevention, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0003-2885-8538
Sabine EijsboutsDepartment of Cardiology, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0001-9277-8255
Hareld KempsTelemedicine and Rehabilitation in Chronic Disease, Flow, Center for Prevention, Máxima MC, Veldhoven/Eindhoven, Netherlands.ORCID https://orcid.org/0000-0003-0272-4355
Radboud University Nijmegen · NLX Flow (Netherlands) · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation is commonly associated with obesity. Observational studies have shown that weight loss is associated with improved prognosis and a decrease in atrial fibrillation frequency and severity. However, despite these benefits, nonadherence to lifestyle programs is common.

objectiveIn this study, we evaluated adherence to and feasibility of a multidisciplinary lifestyle program focusing on behavior change in patients with atrial fibrillation and obesity.

methodsPatients with atrial fibrillation and obesity participated in a 1-year goal-oriented cardiac rehabilitation program. After baseline assessment, the first 3 months included a cardiac rehabilitation intervention with 4 fixed modules: lifestyle counseling (with an advanced nurse practitioner), exercise training, dietary consultation, and psychosocial therapy; relaxation sessions were an additional optional treatment module. An advanced nurse practitioner monitored the personal lifestyle of each individual patient, with assessments and consultations at 3 months (ie, immediately after the intervention) and at the end of the year (ie, 9 months after the intervention). At each timepoint, level of physical activity, personal goals and progress, atrial fibrillation symptoms and frequency (Atrial Fibrillation Severity Scale), psychosocial stress (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) were assessed. The primary endpoints were adherence (defined as the number of visits attended as percentage of the number of planned visits) and completion rates of the cardiac rehabilitation intervention (defined as performing at least of 80% of the prescribed sessions). In addition, we performed an exploratory analysis of effects of the cardiac rehabilitation program on weight and atrial fibrillation symptom frequency and severity.

resultsPatients with atrial fibrillation and obesity (male: n=8; female: n=2; age: mean 57.2 years, SD 9.0; baseline weight: mean 107.2 kg, SD 11.8; baseline BMI: mean 32.4 kg/m2, SD 3.5) were recruited. Of the 10 participants, 8 participants completed the 3-month cardiac rehabilitation intervention, and 2 participants did not complete the cardiac rehabilitation intervention (both because of personal issues). Adherence to the fixed treatment modules was 95% (mean 3.8 sessions attended out of mean 4 planned) for lifestyle counseling, 86% (mean 15.2 sessions attended out of mean 17.6 planned) for physiotherapy sessions, 88% (mean 3.7 sessions attended out of mean 4.1 planned) for dietician consultations, and 60% (mean 0.6 sessions attended out of mean 1.0 planned) for psychosocial therapy; 70% of participants (7/10) were referred to the optional relaxation sessions, for which adherence was 86% (mean 2 sessions attended out of mean 2.4 planned). The frequency of atrial fibrillation symptoms was reduced immediately after the intervention (before: mean 35.6, SD 3.8; after: mean 31.2, SD 3.3), and this was sustained at 12 months (mean 24.8, SD 3.2). The severity of atrial fibrillation complaints immediately after the intervention (mean 20.0, SD 3.7) and at 12 months (mean 9.3, SD 3.6) were comparable to that at baseline (mean 16.6, SD 3.3).

conclusionsA 1-year multidisciplinary lifestyle program for obese patients with atrial fibrillation was found to be feasible, with high adherence and completion rates. Exploratory analysis revealed a sustained reduction in atrial fibrillation symptoms; however, these results remain to be confirmed in large-scale studies.

Indexed as

adherenceatrial fibrillationcardiac rehabilitationcompletionlifestyleobesityparticipation

Identifiers

PMID35486435
PMCPMC9107041
OpenAlexW4206621073

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.