Nurse-led atrial fibrillation management- the NEAT study.

The intervention is 3 months in duration for each study participant. There will be 2 face-to-face visits at the beginning and completion of the intervention, with 4 phone consultations in between. It is expected that the face-to-face visits will take approximately 30 minutes in duration. The intervention is a nurse-led support package which contains the following components: 1. An electronic decision support (EDS) tool A mobile enabled web app designed to facilitate a discussion between the nurse and study participant and to build an individual patient profile. The app will be used by the nurse to take the participant through potential risk factors, lifestyle factors and medication options. The profile is based on the their stroke risk (using the CHAD2S2-VASc score), their medication adherence (using Morisky medication adherence score) and their cardiovascular risk factors and lifestyle choices. The app will be used at baseline and at the 3 month face-to-face follow up visit. 2. Health counselling and goal setting At the baseline visit, the nurse will provide education and the pathophysiology of AF, its symptoms and possible complications. The nurse will discuss rate and rhythm control as well as prophylactic vascular therapy (including strict anti-coagulation monitoring) and information about knowing when to report to hospital. Each study participant randomised to the intervention arm will also receive a booklet entitled “Living with Atrial Fibrillation”. At the baseline visit the nurse will provide behaviour change support, through motivational interviewing principles (Miller & Rollnick, 2012) and use the EDS tool to facilitate the discussion about HR-QoL encouraging patients to set realistic goals in line with their priority and motivation. 3. Three-month telephone-based support and follow up The study participant will receive regular telephone support (minimum of four phone calls in the intervention period) and the nurse will continue to provide psychosocial support and educational interventions as offered at the baseline visit. The length of each phone call will be recorded in the Case Report Form (CRF). The final face-to-face visit (3 months after the baseline visit) will collect the same individual patient data as collected as baseline including but not limited to vital sign measures, quality of life measures, and medication adherence.