Peer-Mentor Support for Vulnerable Patients With Atrial Fibrillation

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with significant symptom burden, reduced quality of life, and high levels of psychological distress. Anxiety is particularly prevalent among patients with AF and may worsen symptom perception, increase health-related worry, and negatively affect engagement in self-management and healthcare. Individuals with low socioeconomic position often experience greater disease burden and face additional barriers to accessing supportive care, contributing to social inequalities in cardiovascular health.

Peer support interventions have shown promising effects in other cardiac populations by providing emotional support, normalization of illness experiences, and practical guidance based on lived experience. Such interventions may enhance patients' confidence in managing their condition and navigating everyday life with chronic illness.

The EMPOWER-AF study aims to evaluate the effectiveness of a peer-mentor intervention designed to support vulnerable patients with AF. The intervention is grounded in social cognitive theory, particularly the concept of self-efficacy, and is intended to strengthen patients' ability to manage symptoms, cope with uncertainty, and improve mental well-being.

The study is conducted as a randomized controlled trial with two parallel groups. Participants are randomized to either a peer-mentor intervention in addition to usual care or usual care alone. The intervention lasts 16 weeks and involves one-to-one support between a trained peer mentor and a patient with AF. Peer mentors are individuals with lived experience of AF who have achieved stable everyday management of the condition and who are trained to provide emotional support and experiential guidance. Contacts between mentors and mentees may take place via telephone, face-to-face meetings, or digital communication depending on participant preferences.

In addition to the randomized trial, the study includes an embedded mixed-methods process evaluation to explore participants' and mentors' experiences, mechanisms of impact, and contextual factors influencing engagement with the intervention.

The study seeks to generate evidence on whether peer-based support can improve mental well-being among vulnerable patients with AF and contribute to more equitable and person-centered care for this patient group.

• Depressive symptoms measured by the Hospital Anxiety and Depression Scale (HADS-D) [Срок оценки: Baseline and 16 weeks]
• Atrial fibrillation-specific quality of life measured by the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) [Срок оценки: Baseline and 16 weeks]
• Self-efficacy measured by the Self-Efficacy for Managing Chronic Disease scale (SES6G) [Срок оценки: Baseline and 16 weeks]
• Use of antidepressants and benzodiazepines based on redeemed prescriptions [Срок оценки: From randomization to 24 weeks and 1 year follow-up]
• Diagnoses of anxiety and depression based on hospital records [Срок оценки: From randomization to 24 weeks and 1 year follow-up]
• Atrial fibrillation-related hospital contacts [Срок оценки: From randomization to 24 weeks and 1 year follow-up]
• Cardiac death and suicide [Срок оценки: From randomization to 24 weeks and 1 year follow-up]