Structured educational program for healthcare professionals improves outcomes of atrial fibrillation management: A Polish subgroup analysis of the European Society of Cardiology STEEER-AF cluster-randomized trial.

BACKGROUND

The STEEER-AF trial evaluated the effect of a structured educational program on adherence to European Society of Cardiology guidelines for atrial fibrillation.

AIMS: We aimed to report the prespecified subgroup analysis of centers in Poland to evaluate regional guideline adherence and the impact of the educational intervention.

METHODS

Twelve Polish centers recruiting 300 patients with atrial fibrillation were randomized 1:1 to an educational intervention for healthcare professionals or standard practice. Co-primary outcomes were patient-level adherence to class I and III European Society of Cardiology recommendations for stroke prevention and rhythm control at 6-9 months.

RESULTS

Complete case analysis included 262 patients. Baseline oral anticoagulant prescription was 96.3%. At follow-up, adherence to stroke prevention guidelines was 76.6% in the intervention group and 70.9% in the control group (adjusted risk ratio, 1.12; 95% confidence interval, 0.99-1.27). For rhythm control, guideline adherence reached 53.1% in the intervention group compared with 26.9% in the control group (adjusted risk ratio 1.75; 95% confidence interval, 1.16-2.64). Educational engagement was robust, with learners spending a median of 11.5 hours on the platform.

CONCLUSIONS

Following structured professional education, absolute adherence to rhythm control recommendations was substantially higher in the Polish cohort. A near-optimal baseline oral anticoagulant prescription rate limited the capacity for measurable improvement in stroke prevention. These findings are hypothesis-generating and highlight the need for targeted education aligned with local healthcare infrastructure.