Atrial Fibrillation integrated approach in FraIl, multimoRbid and polyMedicated Older people: AFFIRMO project

PI: Davide L Vetrano

Assistant Professor in Medicine

AFFIRMO (Atrial Fibrillation integrated approach in FraIl, multimoRbid and polyMedicated Older people) is a randomized clinical trial, which overall aim is to test the effectiveness of an integrated care model for the treatment and care of older persons with atrial fibrillation and multimorbidity.

The project consists of two phases. The first phase aims to produce the scientific evidence to build the health care model – to be tested in the next step – starting from observational data. To this hand, population-based studies (e.g., SNAC-K), atrial fibrillation clinical dataset and registry databases will be explored, and clinically meaningful patterns of multimorbidity, characterizing individuals with atrial fibrillation, will be identified, together with their prognoses and associated care needs. In the second phase, the integrated and multidisciplinary care model will be implemented in several participating European countries and tested in comparison with usual care.

Improving the management of AF in the context of multimorbidity may benefit individuals on a larger scale, with a holistic approach to optimize clinical management of older AF patients taking into account the multifaceted aspects of individuals’ health, including multimorbidity, polypharmacy, personal preferences, and social context. A specific objective will be to develop an interoperable care framework that can facilitate the application of this personalized care pathway, that bridges the continuum between primary and secondary care, with the active involvement of patients with shared decision-making. A further aim will be to model the impact of multimorbidity including AF on healthcare costs and the health economic benefits by the proposed integrated care pathway. Finally, subgroup analyses would assess differences on outcomes of in relation to gender and social inequalities.

AFFIRMO was granted 60 MSEK and will involve 8 countries, including the UK. Karolinska Institutet will receive 5 MSEK.

Researchers at ARC participating in the project

Davide Liborio Vetrano (WP leader), Amaia Calderón-Larrañaga, Chengxuan Qiu, Laura Fratiglioni, Alessandra Marengoni.