Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study

Objective The objective is to explore patients’ perceptions on the management of atrial fibrillation (AF) and associated comorbidities.Design A descriptive qualitative study involving in-depth individual interviews, analysed using Braun and Clarke's approach to Reflexive Thematic Analysis.Setti...

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Main Authors: Stylianos Tzeis, Edward Baker, Bart A Mulder, Hein Heidbüchel, Geraldine Lee, Lien Desteghe, Rana Önder, Rafal Dabrowski, Stavros Karanikas, Miguel Jauregui-Abularach, Daniel Merino
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e094839.full
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author Stylianos Tzeis
Edward Baker
Bart A Mulder
Hein Heidbüchel
Geraldine Lee
Lien Desteghe
Rana Önder
Rafal Dabrowski
Stavros Karanikas
Miguel Jauregui-Abularach
Daniel Merino
author_facet Stylianos Tzeis
Edward Baker
Bart A Mulder
Hein Heidbüchel
Geraldine Lee
Lien Desteghe
Rana Önder
Rafal Dabrowski
Stavros Karanikas
Miguel Jauregui-Abularach
Daniel Merino
author_sort Stylianos Tzeis
collection DOAJ
description Objective The objective is to explore patients’ perceptions on the management of atrial fibrillation (AF) and associated comorbidities.Design A descriptive qualitative study involving in-depth individual interviews, analysed using Braun and Clarke's approach to Reflexive Thematic Analysis.Setting Cardiology departments in teaching hospitals in five geographically diverse European countries—Belgium, Greece, Poland, Spain and the Netherlands.Participants 30 adults aged 65 years or older, diagnosed with AF, with two or more confirmed comorbidities were interviewed.Results The average age was 73 years, 37% were women and the most common comorbidity was hypertension (n=26, 87%), followed by hypercholesterolaemia (n=12, 40%), obesity (n=10, 33%), hypothyroidism (n=9, 30%) and diabetes (n=7, 23%). Three main themes were identified: (1) navigating the diagnosis path and adapting to life with AF, (2) normalising symptoms and treatment burden and (3) striving to build a therapeutic relationship.Respondents had some knowledge about the relationship between comorbidities and AF but lacked understanding of how these comorbidities related to AF. Participants raised concerns regarding their medications, especially anticoagulants, with a desire to be given more information about them. Participants were motivated to make lifestyle adjustments but reported a lack of education and advice on how to implement and maintain these lifestyle changes. Overall, participants were very satisfied with their cardiology/AF teams, and they emphasised the importance of a person-centred approach. There was a perceived disjointedness to healthcare systems, with some reporting multiple appointments at different locations, leading to participants being frustrated and highlighting the lack of integrated care.Conclusions In-depth interviews provided an excellent platform to explore the perceptions and experiences of patients living with AF and associated comorbidities and highlighted the lack of an integrated approach to multimorbid AF management.
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spelling doaj-art-6901219c1ffc4cbab4fbc569d996c7702025-08-20T03:21:27ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-094839Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview studyStylianos Tzeis0Edward Baker1Bart A Mulder2Hein Heidbüchel3Geraldine Lee4Lien Desteghe5Rana Önder6Rafal Dabrowski7Stavros Karanikas8Miguel Jauregui-Abularach9Daniel Merino10Cardiology, Henry Dunant Hospital, Athens, GreeceEmergency Department, King’s College Hospital NHS Foundation Trust, London, UKUniversitair Medisch Centrum Groningen, Groningen, The NetherlandsArrhythmology, Heart Center Hasselt, Hasselt, BelgiumNursing & Midwifery, University College Cork, Cork, IrelandUniversity of Antwerp, Antwerpen, BelgiumHasselt University, Hasselt, BelgiumII Ischemic Heart Disease Dep, Institute of Cardiology, Warsaw, PolandDepartment of Cardiology, Mitera General and Maternity Hospital, Athens, GreeceLa Paz University Hospital, Madrid, SpainLa Paz University Hospital, Madrid, SpainObjective The objective is to explore patients’ perceptions on the management of atrial fibrillation (AF) and associated comorbidities.Design A descriptive qualitative study involving in-depth individual interviews, analysed using Braun and Clarke's approach to Reflexive Thematic Analysis.Setting Cardiology departments in teaching hospitals in five geographically diverse European countries—Belgium, Greece, Poland, Spain and the Netherlands.Participants 30 adults aged 65 years or older, diagnosed with AF, with two or more confirmed comorbidities were interviewed.Results The average age was 73 years, 37% were women and the most common comorbidity was hypertension (n=26, 87%), followed by hypercholesterolaemia (n=12, 40%), obesity (n=10, 33%), hypothyroidism (n=9, 30%) and diabetes (n=7, 23%). Three main themes were identified: (1) navigating the diagnosis path and adapting to life with AF, (2) normalising symptoms and treatment burden and (3) striving to build a therapeutic relationship.Respondents had some knowledge about the relationship between comorbidities and AF but lacked understanding of how these comorbidities related to AF. Participants raised concerns regarding their medications, especially anticoagulants, with a desire to be given more information about them. Participants were motivated to make lifestyle adjustments but reported a lack of education and advice on how to implement and maintain these lifestyle changes. Overall, participants were very satisfied with their cardiology/AF teams, and they emphasised the importance of a person-centred approach. There was a perceived disjointedness to healthcare systems, with some reporting multiple appointments at different locations, leading to participants being frustrated and highlighting the lack of integrated care.Conclusions In-depth interviews provided an excellent platform to explore the perceptions and experiences of patients living with AF and associated comorbidities and highlighted the lack of an integrated approach to multimorbid AF management.https://bmjopen.bmj.com/content/15/6/e094839.full
spellingShingle Stylianos Tzeis
Edward Baker
Bart A Mulder
Hein Heidbüchel
Geraldine Lee
Lien Desteghe
Rana Önder
Rafal Dabrowski
Stavros Karanikas
Miguel Jauregui-Abularach
Daniel Merino
Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
BMJ Open
title Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
title_full Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
title_fullStr Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
title_full_unstemmed Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
title_short Patients’ experiences of atrial fibrillation and comorbidity management in clinical practice: a pan-European qualitative descriptive interview study
title_sort patients experiences of atrial fibrillation and comorbidity management in clinical practice a pan european qualitative descriptive interview study
url https://bmjopen.bmj.com/content/15/6/e094839.full
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