Catheter ablation on atrial fibrillation: educational needs among physicians

Abstract

Atrial Fibrillation (AF) is a rapid and irregular heart rate that increases the risk of strokes, heart failure, and other heart-related complications and can have an effect on a day-to-day basis. In some cases, the episodes may come and go. In other cases, AF does not go away and may require treatment. The common symptoms accompanied by AF are palpitations, dizziness, and/or chest pain. Possible causes of AF are patient age, family history, lifestyle habits, and other medical conditions. There are two patient types, ones that have AF but do not feel the symptoms (asymptomatic) and others who feel the symptoms for years (symptomatic). Additionally, there are different levels of AF: paroxysmal, persistent, and long-standing persistent. While AF is not life-threatening, it is a matter that needs to be taken seriously as soon as symptoms start to show, or a person is diagnosed because there is a higher possibility for more effective treatment at an earlier stage. Abbott, the American medical devices and healthcare company, has several products tailored for different diseases. Its cardiovascular division is one that addresses heart and blood vessel disease. One of the treatment options of AF is catheter ablation. Through its cardiovascular offerings, Abbott has the device to help specialized physicians perform the catheter ablation. Catheter ablation is developing exponentially and is one of the most performed electrophysiology procedures. The purpose of this paper is to investigate the educational needs of physicians related to catheter ablation in the Belgian market. Afterwards, solutions addressing these needs are proposed. The reason behind this investigation is that catheter ablation therapy penetration is currently only at 3%. This is low in comparison to patients who have AF. Two main topics are addressed throughout the report, educational needs and catheter ablation. Educational needs are considered from the physicians’ perspective. Commonly, there are three main physicians involved in the life of an AF patient: general practitioner (GP), general cardiologist (GC), and electrophysiologist (EP). Physicians are typically involved in continuous education and lifelong learning as their field requires them to constantly be up to date. The different current educational tools of each physician type are addressed, including newspapers, publications, seminars, etc. While each type of physician might have different current educational offerings, they similarly are less mature about digital educational offerings. Understandably, traditional methods are inevitable. However, digital readiness in this field brings higher benefits to patients, physicians, and the mother company. As for patients, there is a gap in their knowledge level about AF. It is remarkable to note that only 20% of physicians felt that enough educational information was provided to the patients. As a result, communicating with the patient should be done to address their concerns, understanding, and resistance to therapy because early assessment and education interference would improve health results on a long-term basis. In order to treat AF, catheter ablation and antiarrhythmic drug (AAD) therapy are options. This paper highlights the difference between them in terms of quality of life, recurrence rate, stroke risk, and mortality rate. Depending on the case of the patient, one method could be preferred over the other. But because catheter ablation is a relatively new method, physicians need to be more educated about the success rates and safety of the procedure to be able to trust the procedure more and refer the right candidate to the right treatment method. The main methods of gathering data was desk research and interviews, so both secondary and primary data were conducted, respectively. A qualitative research was conducted and interpretative phenomenological analysis (IPA) was applied to analyze the data. The interviews were conducted with different types of participants to have a well-rounded understanding of the end-to-end process. Semi-structured interviews were conducted with Abbott’s education team, Abbott’s health economics department, 5 GPs, 5 GCs, 5 EPs, doctoral student, and finally medical young students. Moving on to the findings, they are divided into the following: 1) Abbott’s direct competitors offer more or less similar training and educational programs. 2) Abbott’s EP education team, insights about Abbott’s education framework was studied. 3) Abbott’s health economics and reimbursement team highlighted the policies and procedures in the Belgian market. 4)GPs do not always have sufficient knowledge about catheter ablation. Additionally, the trust relationship they hold with their patients is highly valued. 5) GCs often lack knowledge about catheter ablation and therefore do not always trust the ablation procedure.6) EPs get the patients referred too late from the GCs side. One reason is that some GCs lack the knowledge on the effectiveness and safety of the procedure. 7)Young medical students’ perspective on educational and training methods confirmed the need to have them through both traditional as well as digital means 8) A patient pathway was articulated based on the interviews conducted. This includes the different roads a patient can take, who they consult, and how long it takes to move to the next step in the treatment method. Finally, immediate and alternative solutions are proposed to the company comprising of both traditional and digital means. As mentioned, solutions were tailored to both physicians and patients. For physicians, the company can partner with one of the organizations centring around young cardiologists’ education. Moreover, collaborating with a third-party website to act as a credible and trusted source for physicians is recommended. Additionally, enhancing the current website’s offerings to tailor to the needs of physicians is suggested. On the other hand, for patients, it is important to have them educated about AF to be able to have the treatment at the right time. The company can explain the whole AF process, what help they can get, how to treat AF, and have stories of other patients shared so they feel they’re not alone. Another solution is to provide GPs with booklets in which they could give it to the patients to make them more aware of AF and how to deal with it. The initial phase could start with rural areas since there is a higher opportunity to educate general practitioners more in smaller cities or rural areas. As for the alternative solutions, seminars or panel discussions could be organized in rural areas where relevant topics and latest updates on the industry are shared. This will be an opportunity for different physician types to communicate and share ideas together. This will lead to trust, which is a very important element.