Abstract 12392: Describing Burden of Atrial Fibrillation Using a Patient-Level National Survey
Objective and Methods: The 2009 National Health and Wellness Survey is a patient-reported, internet-based questionnaire administered to a nationwide sample of adults (n=75,000) stratified by age, gender, and race. Primary objective: to assess the burden of illness associated with atrial fibrillation (AF) and certain AF medication combinations. Regression analyses compared patients diagnosed with AF (n=1279) with all patients not diagnosed with AF.
Results: The data indicated that among the total US adult population surveyed, 2% reported experiencing AF, 70% of whom were on prescription therapy. Patients with AF were more often male, Caucasian, ≥65 years of age, on Medicare, and retired. In the previous 6 months, they were significantly more likely to have contacted a healthcare provider or to have visited an emergency room (p<0.0001). Of patients with AF, 13% had undergone ablation, 60% were receiving rate and/or rhythm control medication, 43% were prescribed an antiplatelet agent but no anticoagulant, 35% were not receiving any form of antithrombotic medication, and only 22% were receiving warfarin. Therefore a large proportion of patients with AF are still not receiving guideline-recommended therapy. Patients with AF reported increased levels of co-morbidities; in addition to those expected (stroke, hypertension, and diabetes), the survey identified several others, including gastroesophogeal reflux disease, malignancy, and COPD. The overall increase in co-morbidity burden persists after age adjustment. Observed quality of life measures were lower and activity impairment was significantly higher (p<0.0001) among patients with AF, even after adjusting for demographics and patient variables. Patients with AF reported worse physical functioning but not mental functioning. Work impairment measures were not significantly different for patients with AF, possibly because patients with AF were older and less likely to be employed (25.6%). However, mean levels of impairment were higher among patients with AF.
Conclusions: AF continues to impose a significant burden for both patients and healthcare utilization. Improved adherence to guidelines could potentially reduce the burden of AF, which might also be expected to improve clinical outcomes.
- © 2010 by American Heart Association, Inc.