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Education of Healthcare Professionals to Improve Guideline Adherence in Atrial Fibrillation: The STEEER-AF Cluster-Randomized Clinical Trial
Friday, June 27, 2025

Education of Healthcare Professionals to Improve Guideline Adherence in Atrial Fibrillation: The STEEER-AF Cluster-Randomized Clinical Trial

By: Nature Medicine

Nature Medicine (06/25) Kotecha, Dipak; Bunting, Karina V.; Mehta, Samir; et al.

An international cluster-randomized trial assessed if educating healthcare professionals (HCPs) improved patient adherence to atrial fibrillation (AF) guidelines. The study, which was conducted at 70 centers in six countries, included a total of 1,732 patients with AF recruited from routine practice. The centers were then randomized, taking into consideration their baseline adherence to the European Society of Cardiology's Class I and III recommendations for stroke prevention and rhythm control. For HCPs in the intervention centers, there was a 16-week structured educational program that averaged 9 hours of online engagement. HCPs working at control centers were not given extra training beyond what is considered standard. While guideline adherence for stroke prevention improved in both groups, the intervention group showed a greater improvement, increasing from 63.4% to 67.5% compared with the control group's increase from 58.6% to 60.9%; this difference was not statistically significant. Guideline adherence for rhythm control in the intervention group increased to 33.9% from 21.4% at baseline compared with 22.9% from 20.4% at baseline in the control group. Patient-reported integrated AF management increased 5.1% in the intervention group compared with the control group. Based on the findings, the researchers concluded that although "the education of healthcare professionals improved substantial gaps in implementation for rhythm control, it had no significant effect on stroke prevention."

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