Managing the Increasing Burden of Atrial Fibrillation through Integrated Care in Primary Care: A Cost-Effectiveness Analysis.

Carline J van den Dries, Miriam P van der Meulen, Geert W J Frederix, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing

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In one paragraph

Article in International journal of integrated care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

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

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Carline J van den Dries *Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0001-7602-3522

Miriam P van der Meulen *Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0001-7352-9974

Geert W J FrederixJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0002-0355-3466

Arno W HoesJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0002-8747-6479

Karel G M MoonsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0003-2118-004X

Geert-Jan GeersingJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Str. 6.131, PO Box 85500, 3508 GA Utrecht, the Netherlands.ORCID https://orcid.org/0000-0001-6976-9844

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Integrated care for patients with atrial fibrillation (AF) in primary care reduced mortality compared to usual care. We assessed the cost-effectiveness of this approach. Methods: Dutch primary care practices were randomised to provide integrated care for AF patients or usual care. A cost-effectiveness analysis was performed from a societal perspective with a 2-year time horizon to estimate incremental costs and Quality Adjusted Life Years (QALYs). A sensitivity analysis was performed, imputing missing questionnaires for a large group of usual care patients. Results: 522 patients from 15 intervention practices were compared to 425 patients from 11 usual care practices. No effect on QALYs was seen, while mean costs indicated a cost reduction between €865 (95% percentile interval (PI) -€5730 to €3641) and €1343 (95% PI -€6534 to €3109) per patient per 2 years. The cost-effectiveness probability ranged between 36% and 54%. In the sensitivity analysis, this increased to 95%-99%. Discussion: Results should be interpreted with caution due to missing information for a large proportion of usual care patients. Conclusion: The higher costs from extra primary care consultations were likely outweighed by cost reductions for other resources, yet this study doesn't give sufficient clarity on the cost-effectiveness of integrated AF care.

Indexed as

atrial fibrillationcost-effectivenessintegrated caremultimorbidityprimary care

Identifiers

PMID37151778

DOI10.5334/ijic.5661

PMCPMC10162350

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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.