{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:12:32Z","timestamp":1777918352583,"version":"3.51.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T00:00:00Z","timestamp":1708732800000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023699","name":"Health Data Research UK","doi-asserted-by":"publisher","award":["HDR-9006"],"award-info":[{"award-number":["HDR-9006"]}],"id":[{"id":"10.13039\/501100023699","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014589","name":"Chief Scientist Office of the Scottish Government Health and Social Care Directorates","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100014589","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100010756","name":"Health and Social Care Research and Development Division","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010756","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001626","name":"Public Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001626","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Administrative Data Research UK"},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/S007393\/1"],"award-info":[{"award-number":["ES\/S007393\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The Atrial fibrillation Better Care (ABC) pathway is the gold-standard approach to atrial fibrillation (AF) management, but the effect of implementation on health outcomes in care home residents is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To examine associations between ABC pathway adherence and stroke, transient ischaemic attack, cardiovascular hospitalisation, major bleeding, mortality and a composite of all these outcomes in care home residents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study of older care home residents (\u226565\u00a0years) in Wales with AF was conducted between 1 January 2003 and 31 December 2018 using the Secure Anonymised Information Linkage Databank. Adherence to the ABC pathway was assessed at care home entry using pre-specified definitions. Cox proportional hazard and competing risk models were used to estimate the risk of health outcomes according to ABC adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 14,493 residents (median [interquartile range] age 87.0 [82.6\u201391.2] years, 35.2% male) with AF, 5,531 (38.2%) were ABC pathway adherent. Pathway adherence was not significantly associated with risk of the composite outcome (adjusted hazard ratio, 95% confidence interval [CI]: 1.01 [0.97\u20131.05]). There was a significant independent association observed between ABC pathway adherence and a reduced risk of myocardial infarction (0.70 [0.50\u20130.98]), but a higher risk of haemorrhagic stroke (1.59 [1.06\u20132.39]). ABC pathway adherence was not significantly associated with any other individual health outcomes examined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>An ABC adherent approach in care home residents was not consistently associated with improved health outcomes. Findings should be interpreted with caution owing to difficulties in defining pathway adherence using routinely collected data and an individualised approach is recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afae021","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T06:53:45Z","timestamp":1708757625000},"source":"Crossref","is-referenced-by-count":5,"title":["Adherence to the Atrial fibrillation Better Care pathway and the risk of adverse health outcomes in older care home residents with atrial fibrillation: a retrospective data linkage study 2003\u201318"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0392-1767","authenticated-orcid":false,"given":"Leona A","family":"Ritchie","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool , 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UK"},{"name":"Registry of Senior Australians, South Australian Health and Medical Research Institute , Adelaide, SA , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6763-1489","authenticated-orcid":false,"given":"Peter E","family":"Penson","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool , UK"},{"name":"School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University , Liverpool L3 3AF , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Akbari","sequence":"additional","affiliation":[{"name":"Population Data Science , Swansea University Medical School, , Swansea, Wales SA2 8PP , UK"},{"name":"Swansea University , Swansea University Medical School, , Swansea, Wales SA2 8PP , 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P","family":"Halcox","sequence":"additional","affiliation":[{"name":"Population Data Science , Swansea University Medical School, , Swansea, Wales SA2 8PP , UK"},{"name":"Swansea University , Swansea University Medical School, , Swansea, Wales SA2 8PP , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Department of Public Health , Policy and Systems, Institute of Population Health, , Liverpool L69 3GF , UK"},{"name":"University of Liverpool , Policy and Systems, Institute of Population Health, , Liverpool L69 3GF , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool , UK"},{"name":"Department of Cardiovascular and Metabolic Medicine , Institute of 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