A pilot study of the quality of care of atrial fibrillation in Irish general practice

Aim The aim of this pilot study is to develop and test a quality of care score for patients with permanent atrial fibrillation (AF) in general practice, and identify the patterns of quality of care using this score. We developed a quality of care score based on the Atrial Fibrillation Better Care pathway recommended by the European Society of Cardiology and the European Heart Rhythm Association guidelines. This is a 14-point score that we have termed the MAGIC score(Management of Atrial Fibrillation in Integrated Care and General Practice). Methods & Results An observational cross-sectional pilot study was undertaken. Proportionate sampling was used across 11 practices from the Ireland East practice-based research network. The GPs completed a report form on each patient provided by the research team by undertaking a retrospective chart review. 11 practices participated with a total number of 1855 patients with AF. We received data on 153 patients. The main findings were that: No patient met all 14 guideline based recommendations Mean MAGIC score was 11.3 Points were most commonly deducted because the creatinine-clearance and HAS-BLED score were not recorded and the patient was not on the correct dose of oral anti-coagulation. Conclusion This study demonstrates the feasibility of using a quality of care score to measure quality of AF management in general practice. This scoring system; which is based on internationally recognised quality of care markers, highlights key areas that can be targeted with intervention to improve care.