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
Year: 2026
Type: article
Abstract: 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.
Source: Kardiologia Polska
Authors: Wiktor K Gmiński, Paweł Balsam, Jarosław Blicharz, Piotr Buchta, Tomasz Czerski, Robert Gajda, Adam Gorlo, Monika Lica-Gorzyńska, Marcin Kostkiewicz, Wojciech Kucejko, Piotr Pączek, Grzegorz Skonieczny, Andrzej Skrzyński, Grzegorz Sobieszek, Stanisław Tubek, Hanna Wilk-Manowiec, Karina V Bunting, Samir Mehta, Isabelle Van Gelder, Giuseppe Boriani, Serge Boveda, Eduard Guasch, Lluis Mont, Kim Rajappan, Phillipp Sommer, Dipak Kotecha, Maciej Sterliński, On behalf of the STEEER-AF Investigators
Institutions: Provincial Polyclinical Hospital in Toruń, Medical University of Warsaw, Medical University of Silesia, Silesian Center for Heart Disease, NeuroVita Clinic, Fukui CardioVascular Center, Medical University of Białystok, John Paul II Catholic University of Lublin, 1 Military Clinical Hospital with Outpatient Clinic, Wroclaw Medical University, Samodzielny Publiczny Zakład Opieki Zdrowotnej RM-MEDITRANS Stacja Pogotowia Ratunkowego i Transportu Sanitarnego w Siedlcach, National Health Service, University Hospitals Birmingham NHS Foundation Trust, NIHR Birmingham Biomedical Research Centre, University of Birmingham, University Medical Center Groningen, University of Groningen, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Vrije Universiteit Brussel, Clinique Pasteur, Centro de Investigación en Red en Enfermedades Cardiovasculares, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Institute of Cardiology
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204255336
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