Vascular Health and Risk Management (Sep 2022)

Screening for Atrial Fibrillation by Village Doctors in Rural Areas of China: The Jiangsu Province Rural Community AF Project

  • Li M,
  • Shi J,
  • Chu M,
  • Shen Y,
  • Zhang S,
  • Sun X,
  • Zhang H,
  • Yan Q,
  • Gong J,
  • Lip GYH,
  • Chen M

Journal volume & issue
Vol. Volume 18
pp. 757 – 766

Abstract

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Mingfang Li,1 Jiaojiao Shi,1 Ming Chu,1 Youmei Shen,1 Shimeng Zhang,1 Xingxing Sun,1 Hengli Zhang,1 Qing Yan,1 Jinlong Gong,2 Gregory YH Lip,3,4 Minglong Chen1,5 1Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 2Division of Cardiology, Jiangdu People’s Hospital, Yangzhou, People’s Republic of China; 3Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK; 4Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 5Division of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of ChinaCorrespondence: Minglong Chen, Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People’s Republic of China, Tel +86-25-68303115, Fax +86-25-6813-6479, Email [email protected]: China has a large population of elderly in rural areas. Village doctors are acting as health-care gatekeepers for the rural elderly in China and are encouraged to provide more long-term care for patients with chronic diseases such as atrial fibrillation (AF). The data of AF registries from the rural elderly are limited. The present registry aims to provide contemporary data on the current AF-related health status of the rural elderly and the gaps in management of AF by village doctors. This study has two phases. The first phase is a cross-sectional study of AF screening in two rural towns of eastern China. All the residents aged ≥ 65 years are eligible and will be invited to attend a government-led health examination or an in-house AF screening program. The AF detection rate, the awareness of AF and the usage of oral anticoagulants and smartphones by AF patients, and the ability to diagnose and manage AF by village doctors will be assessed. Participants with AF detected in the first phase are eligible for the second phase. A variety of modes of intensified education will be provided to all AF patients and their family members to enrich their AF-related knowledge. Their village doctors will be offered a lecture-based training program focusing on Atrial fibrillation Better Care (ABC) pathway. Follow-up will be conducted for 1 year. The primary endpoint is the composite of all stroke and all-cause mortality. The first phase of AF screening was conducted between April 2019 and June 2019, and 18,712 participants with the mean age of 73.1± 5.8 years were enrolled. The second phase that includes 810 patients with AF, started on 1 May 2019. This study will provide a perspective of primary care system and would indirectly reflect the current status of chronic disease care in rural China.Keywords: atrial fibrillation, elderly, village doctors, rural China

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