The Interpro AFib Forum will take place January 26-27, 2019 at the Boston Seaport Hotel in Boston, Massachusetts. In this feature interview, EP Lab Digest speaks with Andrea M. Russo, MD, FHRS, Heart Rhythm Society (HRS) President-Elect and Chair of the Interpro AFib Forum, and Anne Marie Smith, MBA, PMP, Vice President of Quality Improvement Education at HRS, about the inaugural meeting.
How did the concept for the Interpro AFib Forum come about? Why is there a need for interdisciplinary learning?
HRS is committed to addressing stroke prevention for patients with atrial fibrillation. Patients with AFib have a fivefold increased risk of stroke, and death and disability from stroke caused by AFib are particularly high. Thus, stroke related to AFib is a substantial and growing public health burden. In addition, studies show significant gaps in care related to thromboembolic prophylaxis for patients at moderate to high risk for stroke. The Interpro AFib Forum was conceived and organized by HRS leadership and staff seeking ways to improve evidence-based care for patient with AFib. Through discussions between volunteers and staff, it has become clear that an interdisciplinary approach involving a variety of healthcare professionals is needed for effective treatment of patients with atrial fibrillation.
When we looked at the gaps in stroke prevention, two things became readily apparent: (1) many patients with AFib are not receiving beneficial anticoagulation, often due to concerns about bleeding and frailty that can be addressed; and (2) patients with AFib are seen by, or interact with, a wide spectrum of health care professionals, including nurses, PAs, NPs, pharmacists, primary care physicians, cardiologists, neurologists, emergency room physicians, electrophysiologists, and more. It became clear that there could be a tremendous benefit in bringing together all of these care providers to explore how to ensure that patients receive optimal care, that care is well coordinated, and that referrals are made in a timely fashion for patients with complex needs.
In addition to anticoagulation, many options for treatment of patients with AFib are currently available. Treatment options include rhythm control with medication or non-pharmacological therapy. Catheter ablation options may be more successful if instituted earlier in the disease. For patients who are not candidates for anticoagulation, left atrial appendage closure may be an option to prevent stroke. Therefore, several therapeutic options may be considered and discussed with patients using an integrated approach to deliver the highest quality care.
Why will the meeting be taking place following the 23rd Annual International Atrial Fibrillation Symposium? How will the two meetings differ? Is the expectation that participants will attend both meetings?
The annual symposium led by Dr. Jeremy Ruskin brings together world-renowned experts in heart rhythm care. We saw tremendous synergy between the goals of the two conferences and some potential overlap for faculty and learners. The difference is that while Dr. Ruskin’s meeting primarily addresses the educational needs of electrophysiologists, the Interpro AFib Forum will focus on the needs of the entire healthcare care team, which includes cardiologists, internists, family practitioners, emergency room physicians, nurses, nurse practitioners, physician assistants, administrators, electrophysiologists, and others. We would love to have Dr. Ruskin’s participants attend Interpro AFib Forum, and bring their colleagues and care teams with them!
Why is a multidisciplinary approach (e.g., involving primary care providers, neurologists, pharmacists, etc.) important in the treatment of atrial fibrillation?
A recent systematic review and meta-analysis found that the use of an integrated care approach for AFib is associated with reduced cardiovascular hospitalizations and all-cause mortality.1 While most practices are not yet employing an integrated approach, the first step is to take a multidisciplinary approach involving all care providers. HRS intends to further explore how the Society can be most impactful in helping health systems move toward an integrated care approach.
What can attendees expect at the Interpro AFib Forum? For example, tell us about the “flipped classroom” format to allow more time for interactivity.
Interaction among the expert panelists and the audience is a primary goal for the Interpro AFib Forum. While a complete AFib curriculum covers a lot of ground, particularly with the new AFib guidelines expected to be released in the coming month, we wanted to ensure that there was ample time for interaction. The “flipped classroom” approach will allow participants to review the science at their leisure, before or after the program. Each presentation will be limited to 10 minutes, and faculty have been instructed to focus on the highlights of their topic. The agenda is broken into six parts, with each part including 4-5 faculty presentations, a case discussion, and 20 minutes of panel/audience interaction. The interactive component, where the audience can ask questions and participate in a lively discussion, will enhance the educational experience.
What other aspects are unique about this meeting?
We have invited a well-known patient advocate, Melanie True Hills of StopAfib.org, to provide the patient perspective. Too often, clinician education misses the patient voice. Especially for AFib, when adherence to medication is so important to prevent strokes, we need clinicians to understand patient concerns and barriers.
Why should people attend the Interpro AFib Forum? What do you hope to be the main takeaways of this meeting?
People should attend to help us move the needle toward improved care and outcomes for patients with AFib. We want to prevent strokes due to AFib, and we know that is an achievable goal.
Is the Interpro AFib Forum expected to become an annual event?
We certainly hope so. We would love for the Interpro AFib Forum to be as much of a “must attend” event for the AFib care team as the Atrial Fibrillation Symposium is for EPs.
What CME opportunity is available to attendees?
Physicians can receive up to 7 CME credits and MOC points. Certificates of participation will be provided for other members of the care team. We have found that many other professions accept AMA PRA Category 1 credit™ for their own credentials.
What changes do you think we’ll see in the treatment of AFib in the coming year? For example, do you expect an increase of specialized AFib centers of excellence in the U.S.?
We are definitely seeing a move toward AFib Centers of Excellence, and the Society is exploring how we can help, especially with regard to setting standards and providing protocols that work.
Is there anything else you’d like to add?
We are so excited about this opportunity to reach out to colleagues who share our commitment to quality care. The Interpro AFib Forum will be one educational activity that will allow us to learn as much as we teach!
For more information, please visit: https://www.interproafib.org/
- Gallagher C, Elliott AD, Wong CX, et al. Integrated care in atrial fibrillation: a systematic review and meta-analysis. Heart. 2017;103:1947-1953.