Structured educational program for healthcare professionals improves outcomes of atrial fibrillation management: A Polish subgroup analysis of the European Society of Cardiology STEEER-AF cluster-randomized trial

BACKGROUND: The STEEER-AF trial evaluated the effect of a structured educational program on adherence to European Society of Cardiology guidelines for atrial fibrillation. AIMS: We aimed to report the prespecified subgroup analysis of centers in Poland to evaluate regional guideline adherence and the impact of the educational intervention. METHODS: Twelve Polish centers recruiting 300 patients with atrial fibrillation were randomized 1:1 to an educational intervention for healthcare professionals or standard practice. Co-primary outcomes were patient-level adherence to class I and III European Society of Cardiology recommendations for stroke prevention and rhythm control at 6-9 months. RESULTS: Complete case analysis included 262 patients. Baseline oral anticoagulant prescription was 96.3%. At follow-up, adherence to stroke prevention guidelines was 76.6% in the intervention group and 70.9% in the control group (adjusted risk ratio, 1.12; 95% confidence interval, 0.99-1.27). For rhythm control, guideline adherence reached 53.1% in the intervention group compared with 26.9% in the control group (adjusted risk ratio 1.75; 95% confidence interval, 1.16-2.64). Educational engagement was robust, with learners spending a median of 11.5 hours on the platform. CONCLUSIONS: Following structured professional education, absolute adherence to rhythm control recommendations was substantially higher in the Polish cohort. A near-optimal baseline oral anticoagulant prescription rate limited the capacity for measurable improvement in stroke prevention. These findings are hypothesis-generating and highlight the need for targeted education aligned with local healthcare infrastructure.

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Publication Details

Journal
Kardiologia Polska
Published
2026-08-26
DOI
https://doi.org/10.33963/v.phj.114470
Primary Topic
Atrial Fibrillation Management and Outcomes
Type
article
Field-Weighted Citation Impact
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article

Structured educational program for healthcare professionals improves outcomes of atrial fibrillation management: A Polish subgroup analysis of the European Society of Cardiology STEEER-AF cluster-randomized trial

Karina V Bunting, Marcin Kostkiewicz, Piotr Pączek, Piotr Buchta et al.
Kardiologia Polska
Atrial Fibrillation Management and Outcomes
article

Structured educational program for healthcare professionals improves outcomes of atrial fibrillation management: A Polish subgroup analysis of the European Society of Cardiology STEEER-AF cluster-randomized trial

Karina V Bunting, Marcin Kostkiewicz, Piotr Pączek, Piotr Buchta, Wojciech Kucejko, Monika Lica-Górzyńska, Andrzej Skrzyński, Grzegorz Sobieszek, Adam Gorlo, Robert Gajda, Hanna Wilk-Manowiec, J. Blicharz, Phillipp Sommer, Tomasz Czerski, Wiktor K Gmiński, Isabelle van Gelder, E Guasch, Maciej Sterliński, Samir Mehta, Grzegorz Skonieczny, Paweł Balsam, Dipak Kotecha, Serge Boveda, Stanisław Tubek, Giuseppe Boriani, On behalf of the STEEER-AF Investigators, Kim Rajappan, Lluis Mont
article en

Abstract

BACKGROUND: The STEEER-AF trial evaluated the effect of a structured educational program on adherence to European Society of Cardiology guidelines for atrial fibrillation. AIMS: We aimed to report the prespecified subgroup analysis of centers in Poland to evaluate regional guideline adherence and the impact of the educational intervention. METHODS: Twelve Polish centers recruiting 300 patients with atrial fibrillation were randomized 1:1 to an educational intervention for healthcare professionals or standard practice. Co-primary outcomes were patient-level adherence to class I and III European Society of Cardiology recommendations for stroke prevention and rhythm control at 6-9 months. RESULTS: Complete case analysis included 262 patients. Baseline oral anticoagulant prescription was 96.3%. At follow-up, adherence to stroke prevention guidelines was 76.6% in the intervention group and 70.9% in the control group (adjusted risk ratio, 1.12; 95% confidence interval, 0.99-1.27). For rhythm control, guideline adherence reached 53.1% in the intervention group compared with 26.9% in the control group (adjusted risk ratio 1.75; 95% confidence interval, 1.16-2.64). Educational engagement was robust, with learners spending a median of 11.5 hours on the platform. CONCLUSIONS: Following structured professional education, absolute adherence to rhythm control recommendations was substantially higher in the Polish cohort. A near-optimal baseline oral anticoagulant prescription rate limited the capacity for measurable improvement in stroke prevention. These findings are hypothesis-generating and highlight the need for targeted education aligned with local healthcare infrastructure.

Kardiologia Polska
John Paul II Catholic University of Lublin (PL), University of Modena and Reggio Emilia (IT), University Hospitals Birmingham NHS Foundation Trust (GB), University Medical Center Groningen (NL), Vrije Universiteit Brussel (BE), Medical University of Białystok (PL), Medical University of Silesia (PL), University of Groningen (NL), Medical University of Warsaw (PL), Heart and Diabetes Center North Rhine-Westphalia (DE), Oxford Health NHS Foundation Trust (GB), Caritas Medical Centre (CN), Akademia Tarnowska (PL), Pułtusk Academy of Humanities (PL), University College Birmingham (GB), Wroclaw Medical University (PL), Centro de Investigación en Red en Enfermedades Cardiovasculares (ES), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Azienda Ospedaliero-Universitaria di Modena (IT), Centro de Investigación Biomédica en Red (ES), Hospital Clínic de Barcelona (ES), Silesian Center for Heart Disease (PL), Cancer Research UK Clinical Trials Unit (GB), Institute of Cardiology (PL), Central Clinical Hospital (PL), Clinique Pasteur (FR), Oxford University Hospitals NHS Trust (GB), Provincial Polyclinical Hospital in Toruń (PL), Grochowski Hospital (PL), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), York District Hospital (US), Institute of Occupational Medicine and Environmental Health (PL), NIHR Birmingham Biomedical Research Centre (GB), Oldham Council (GB), Medical Technologies (Czechia) (CZ), Universitat de Barcelona (ES), University of Birmingham (GB)
Pfizer, Boston Scientific Corporation, European Society of Cardiology, Daiichi Sankyo Europe
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Openalex Percentile: Top 10%
Atrial Fibrillation Management and Outcomes
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