Abstract
Background/Aims The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a novel disease-specific quality-of-life (QoL) instrument for patients with atrial fibrillation/flutter (AF/F). The AFEQT, which evaluates a patient’s perception of their AF/F symptoms, physical function, and emotional health, can serve as a marker of quality of care. To date, there are no reports of its practical performance. We describe the feasibility of simplifying the AFEQT for short-term QoL assessments via phone within a diverse population of AF/F patients receiving Emergency Department (ED) care across seven community hospitals.
Methods As part of a multicenter observational study of ED management and short-term outcomes of AF/F patients, we adapted the AFEQT for use in one month phone follow-up in patients with newly diagnosed or recent-onset (less than or equal to 48 hours) AF/F. We kept the original 20-item AFEQT format, but condensed the 7-point Likert response scale to 5 for ease of interviewing. We added questions about health in weeks prior to the ED visit, effectiveness of ED treatment, and medication compliance. The instrument was piloted to assess length and clarity of wording. Patients were consented for participation by phone and excluded if: unable to discriminate between AF/F and other comorbidities; unable to recall diagnosis; too ill to talk; deceased; non-English speaking.
Results Among 1013 patients with newly diagnosed or recent-onset AF/F, 722 (76%) were eligible for an interview. Of these, 620 (86%) were interviewed. Twenty-two (3%) refused to participate; 80 (11%) were lost to follow-up or unreachable. Reasons for refusal included discomfort with discussing health and informed choice not to participate in research. The average time per call in a sample of 106 patients was 11.2 minutes (interquartile range [IQR] 6).
Conclusions These interim results suggest that our modified AFEQT is a practical and feasible research tool for QoL assessments within a diverse subpopulation of AF/F patients. Additional analyses will evaluate QoL scores with relation to patient and treatment factors. Future investigations utilizing this and other disease-specific tools may consider modifications, such as adaptation to phone interview, to match the instrument to the study population and survey modality.
