Table 2

Supporting AF management

ThemeSubthemeReflectionExemplary quote
Supporting AF managementPatient empowermentThe access and cost of medical treatment is a key barrier to patient empowerment.‘In Scotland, I could buy my strips in a local pharmacy. Here I have to be chasing delivery vans for two days at a time because they won’t leave them at my house [if I am not there] because it is a medical delivery. I have to order them three weeks in advance and pay €117 and €20 delivery.’
Doctor–patient communication plays a central role in patient empowerment.‘The biggest fear is asking your doctor or specialist about your condition. Irish people have a habit of not reviewing their medication. They don’t question it and they should. You need to be as informed as possible in order to review your medication.’
Education and health literacy are the biggest barriers to patient empowerment.‘The biggest barrier is medical education. There is also the issue of the medicine management.’
System-based medical care pathwaysNeed to develop a shared vision for an integrated care pathway for AF treatment.‘Can we get an integrated care pathway? We need to get the HSE on board and involve stakeholders at a national level.’
There are a variety of healthcare professionals (primary doctor, pharmacist, nurse) who could provide education and follow-up.‘They could move this out of the hospital and into the community. Patients don’t need the same level of access to the hospital.’
Preventative health measures should be emphasised as opposed to reactionary health measures.‘Currently, 10% of over 65s have an AF screening. The vision would be for at least 75% of over 65 to have a screening.’
Data-driven environment required to maximise the efficiency and effectiveness of AF treatment.‘Practical guidelines, information sharing to keep everyone involved, unique identifiers so that patients do not need to repeatedly tell their story starting from scratch.’
Technological advancementClinician IT empowerment will contribute to increased diagnosis and more efficient decision-making.‘There will likely be an explosion in diagnosis coming with new decision support tools that will be available in the future.’
Patient IT empowerment will contribute to increases in effectiveness and efficiency of diagnosis.‘Patients [using personal devices] get a mobile reading about an acute episode and figure out a way forward. They can get a rapid diagnosis by themselves within 24 hours.’
  • AF, atrial fibrillation; HSE, health services executive; IT, information technology.