Guideline-based education on stroke prevention and rhythm control in atrial fibrillation: A survey in the STEEER-AF study

Abstract Background The value of guideline-related education for healthcare professionals is unknown. The STEEER-AF trial (Stroke prevention and rhythm control Treatment: Evaluation of an Educational programme of the European Society of Cardiology in a cluster-Randomised trial in patients with Atrial Fibrillation) was designed to robustly determine whether an educational programme can improve implementation of class I and III recommendations on stroke prevention and rhythm control in patients with AF. Purpose To evaluate the STEEER-AF educational programme for healthcare professionals designed by the European Society of Cardiology and European Heart Rhythm Association, which combines country-specific online learning and educational resources directed by a local expert trainer. Methods An online survey was distributed to investigators randomised to the STEEER-AF educational programme. The survey included 28 questions on experience, content, the value of national trainers, usability and clinical value, evaluated using Likert scales and free-text responses. Results Seventy survey responses were received from 195 investigators, of which 68 were included in this analysis. 6(9%) were from France, 13(19%) Germany, 8(12%) Italy, 13(19%) Poland, 11(16%) Spain and 16(24%) from the United Kingdom. 19(28%) worked in cardiology-electrophysiology, 24(36%) cardiology other than electrophysiology, 12(18%) internal medicine, 10(15%) primary care and 2(3%) emergency medicine. The median age of respondents was 45(35-55) years and 38(57%) were women. The overall user experience of the educational programme was graded 8 out of 10, with the main quoted strength being its utility in daily practice. 88% agreed or strongly agreed that the programme was relevant to their clinical practice. For stroke prevention, 88% of the respondents agreed or strongly agreed that the content was useful and they would apply the learning to their daily clinical practice. The most useful aspect of the stroke prevention content was treatment advice regarding anticoagulation. For rhythm control, 90% of the respondents agreed or strongly agreed that the content was useful, and 86% indicated they would apply the acquired information in their job. The most useful aspect of the rhythm control content was information about anti-arrhythmic drugs, alternative therapeutic options for rhythm control and their indications. Other strengths of the educational programme overall were related to the format of learning, with an intuitive platform and the availability of an expert trainer to discuss questions in their native language. Suggested future improvements were to reduce the time investment for learners by tailoring the programme to the needs of each individual healthcare professional. Conclusion Healthcare professionals taking part in the STEEER-AF trial educational intervention were positive about the programme, with utility for daily practice and the format of learning being key strengths