Publications by authors named "J Nemis-White"
Article Synopsis
- In rural areas, atrial fibrillation (AF) management is primarily handled by local primary care providers, and there may be differing health outcomes for rural versus urban patients.
- A study analyzed data from the IMPACT-AF trial, comparing a clinical decision support system to standard care for AF management among 1133 patients, with 54.1% living in rural locations.
- Results showed rural patients had more referrals to general internists but fewer to cardiologists, and while there were no overall differences in emergency visits or hospitalizations, rural patients experienced higher rates of recurrent AF-related issues compared to urban patients.
Background: Despite guidelines supporting antithrombotic therapy use in atrial fibrillation (AF), under-prescribing persists. We assessed whether computerized clinical decision support (CDS) would enable guideline-based antithrombotic therapy for AF patients in primary care.
Methods: This cluster randomized trial of CDS versus usual care (UC) recruited participants from primary care practices across Nova Scotia, following them for 12 months.
Article Synopsis
- - The IMPACT-AF trial was conducted in Nova Scotia, Canada, to compare a computerized decision support system (CDS) for managing atrial fibrillation (AF) against traditional care practices in primary care settings.
- - Researchers analyzed resource use and costs over a 12-month period using case costing data, questionnaires, and diaries from participants, finding that emergency visits and hospitalizations were the most significant costs related to AF care.
- - Ultimately, the study found no significant cost differences between the CDS and usual care groups, highlighting the challenges of gathering economic data in clinical trials.
Background: We examined the characteristics and outcomes in a contemporary ambulatory population of patients with atrial fibrillation (AF), comparing rate control with rhythm control.
Methods: This is a post hoc analysis of a cluster-randomized trial (ntegrated anagement rogram dvancing ommunity reatment of trial ibrillation [IMPACT-AF]) in ambulatory AF patients from 2016 to 2018, which compared use of a clinical decision support tool for general practitioners to usual care. This analysis compared patients managed with rate vs rhythm control, at entry into the study.