A short educational program for targeted at health care professionals in France, Germany, Italy, Poland, Spain and the UK increased patient-level adherence to guideline recommendations on atrial fibrillation (AFib) management, based on findings from the STEEER-AF trial presented at ESC Congress 2024 in London.

The trial randomized 70 treatment centers in the six countries to one of two groups. Centers assigned to the control group maintained their existing educational activities for health care professionals, while those assigned to the intervention group implemented an additional 16-week education program for clinicians targeted at stroke prevention, rhythm control and integrated care that was supported by local expert trainers. Across all the centers, 1,732 patients with AFib were studied, with the mean age being 69 years, 37% were women and the mean CHA2DS2-VASc score was 3.2, which researchers noted was consistent with a real-world population.

STEEER-AF's co-primary endpoints were adherence to ESC Class I and III recommendations, at the level of each individual patient, for stroke prevention and rhythm control, which were re-evaluated 6–9 months after randomization. Overall findings found no significant improvements in guideline adherence for stroke prevention, but significant improvements in guideline adherence for rhythm control and in patient-reported evaluations of the eight domains of AFib management. Specifically, guideline adherence for stroke prevention changed from 63.4% to 67.5% in the intervention group compared with a 58.6% to 60.9% change in the control group. On the rhythm control front, adherence increased from 21.4% to 33.9% in the intervention group and only 20.5% to 22.9% in the control group.

"The STEEER-AF trial demonstrates that targeted education for health care professionals can improve patient-level guideline adherence where there are substantial gaps in implementation, as clearly demonstrated for rhythm control in AFib," said Chief Investigator Dipak Kotecha, PhD. "Overall, the care of AFib was poorly adherent to prior guideline recommendations, requiring a total rethink of how guidelines are constructed, disseminated and implemented."