Knowledge and unmet needs of patients with atrial fibrillation in China: a nationwide cross-sectional survey

Abstract

Abstract Background Knowledge about the disease and treatment options is necessary for active patient engagement in shared decision-making, which is essential for ’patient-centered’ atrial fibrillation (AF) management. Purpose To evaluate the knowledge level and identify unmet needs of patients with AF in China. Methods A nationwide cross-sectional survey was conducted using online or paper questionnaires between May and August 2022. Adult AF outpatients or inpatients in China were eligible for participation. The questionnaires included items on knowledge regarding AF, treatment options, risk factors, AF treatment practice, and AF patients’ unmet needs. Results This survey included 2,002 patients with AF [mean age 68.62±13.45, 1,040 (52%) men] from 55 centers across 17 provinces in China. Most patients (66.18%) had knowledge scores of < 4 (an 8-item disease knowledge scale, the score ranged from 0 [worst] to 8 [best]), which is a poor knowledge level. Approximately half of the patients did not know that "AF can cause blood clots which can lead to stroke (cerebral infarction)." The proportion of patients who knew about oral anticoagulants, cardiac rhythm/heart rate control drugs, and catheter ablation were 85.96%, 81.37%, and 41.36%, respectively. However, only 79.52%, 72.08%, and 16.18% of patients received these respective treatments. Moreover, only 51.46% of patients were satisfied or very satisfied with their treatments. The improvement in life quality, prevention and treatment of complications, and symptom control were the three most important aspects for patients when choosing treatments. The impact of AF on daily activities, sleep, emotions, and memory were reported by 80.77%, 63.54%, 52.80%, and 66.18% patients, respectively. Most patients with AF recognized hypertension (87.50%) and diabetes mellitus (50.33%) as risk factors, but few recognized obesity and excessive alcohol intake. Overall, 93.56% of patients obtained AF knowledge from physicians. They expect the source of knowledge to include regular community education(61.29%), as well as digital tools(58.74%) between physicians and patients. Furthermore, 90.86% of patients considered involvement in treatment decisions necessary. Conclusions This study reveals that the knowledge level of patients with AF in China regarding the disease and treatment options is insufficient, and there remain unmet needs for AF management. Thus, more patient-centered education through multiple channels is required to improve patients' involvement in treatment decisions.