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| Name | Class |
|---|---|
| University of Birmingham | OTHER |
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A prospective trial with hospitals/health centres across 6 different European countries, being randomised to either a structured education programme as the intervention or no additional education as the control. To determine whether a comprehensive educational programme for healthcare professionals will increase the rate of appropriate stroke prevention and rhythm control therapy in patients with atrial fibrillation (AF) and adherence to Guidelines.
Prospective, parallel group, two-arm, unblinded, international, cluster-randomized controlled trial.
Intervention arm: A 16-week blended learning programme targeting stroke prevention and rhythm control therapy at the healthcare professional level, with controlled assessments, a commitment to change plan, and reinforcement actions Control arm: No added education of healthcare professionals 70 centres with a cluster size of 25 patients; total estimated number of patients 1750.
8-12 weeks patient recruitment period at each centre; 16 weeks educational intervention period; primary & secondary outcomes at 6-9 months post-randomisation; remote follow-up for clinical events (no new patient contact) at 18 months from randomisation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention arm | Experimental | A 16-week blended learning programme targeting stroke prevention and rhythm control therapy at the healthcare professional level, with controlled assessments, a commitment to change plan, and reinforcement actions |
|
| Control arm | Other | No added education of healthcare professionals |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Education | Behavioral | Randomization between two groups at site level. One cluster with education and one without. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adherence to ESC Guidelines in Atrial Filbrillation | Full adherence to guidelines for stroke prevention rhythm control therapy | 25 months per centre |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of relevant guidelines adhered to | Proportion of relevant guidelines adhered to for stroke prevention and rhythm control | 25 months per centre |
| Measure | Description | Time Frame |
|---|---|---|
| Process outcome | Improvement in knowledge and guideline-adherent practice by healthcare professionals using the educational intervention | 25 months per centre |
Inclusion Criteria:
Exclusion Criteria (patients only):
Patient assessment: Baseline (time of recruitment) and at follow-up routine appointment (6-9 months), plus remote follow-up at 18 months.
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| Name | Affiliation | Role |
|---|---|---|
| Hein Heidbuchel | Universiteit Antwerpen | Study Chair |
| Dipak Kotecha | University of Birmingham | Study Director |
| Isabelle van Gelder | University Medical Center Groningen, The Netherlands | Study Director |
| Serge Boveda | Clinique Pasteur, France | Principal Investigator |
| Philipp Sommer | Ruhr-Universität Bochum, Germany | Principal Investigator |
| Giuseppe Boriani | University of Modena & Reggio Emilia | Principal Investigator |
| Maciej Sterliński | National Institute of Cardiology, Warsaw, Poland | Principal Investigator |
| Luis Mont | University of Barcelona, Spain | Principal Investigator |
| Kim Rajappan | University of Oxford, UK | Principal Investigator |
| Eduard Guasch |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Rennes | Rennes | 'Ille-et-Vilaine, Brittany | 35000 | France | ||
| CHU La Timone |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40514462 | Derived | Kotecha D, Bunting KV, Mehta S, Sommer P, Sterlinski M, Rajappan K, Mont L, Guasch E, Boveda S, Boriani G, Sun Y, van Deutekom C, Gale CP, De Potter TJR, van Gelder IC; STEEER-AF investigators. Education of healthcare professionals to improve guideline adherence in atrial fibrillation: the STEEER-AF cluster-randomized clinical trial. Nat Med. 2025 Aug;31(8):2647-2654. doi: 10.1038/s41591-025-03751-2. Epub 2025 Jun 13. | |
| 38940494 |
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| University of Barcelona, Spain |
| Principal Investigator |
| Marseille |
| Bouches-du-Rhône |
| 13005 |
| France |
| CHU Dijon - Hôpital du Bocage | Dijon | Burgundy | 21000 | France |
| Hôpital Cardiologique du Haut-Lévèque | Pessac | Gironde, Nouvelle-Aquitaine | 33600 | France |
| CHU Dupuytren | Limoges | Haute-Vienne | 87000 | France |
| CHU Nancy, Hôpitaux de Brabois | Nancy | Meurthe-et-Moselle (Lorraine) | 54500 | France |
| CHU Rouen | Rouen | Normandy | 76000 | France |
| CHU Rangueil | Toulouse | Occitanie, Haute-Garonne | 31400 | France |
| CHU Poitiers | Poitiers | Poitou-Charentes | 86000 | France |
| CHU Aix en Provence | Aix-en-Provence | Provence-Alpes-Côte d'Azur Region | 13100 | France |
| Centre Hospitalier de Pau | Pau | Pyrénées-Atlantiques | 64046 | France |
| CHI Toulon La Seyne-sur-Mer Sainte Musse | Toulon | Var | 83100 | France |
| Hôpital Henri Mondor (APHP) | Créteil | Île-de-France Region | 94000 | France |
| CHU Pitié-Salpetrière | Paris | Île-de-France Region | 75013 | France |
| Centre Cardiologique du Nord (CCN) | Saint-Denis | Île-de-France Region | 93200 | France |
| University Hospital Würzburg | Würzburg | Bavaria | 97080 | Germany |
| Segeberger Kliniken GmbH | Bad Segeberg | chleswig-Holstein | 23795 | Germany |
| Herzzentrum Niederrhein Krefeld | Krefeld | North Rhine-Westphalia | 47805 | Germany |
| Heart Centre Bad Neustadt | Neustadt | Rhineland-Palatinate | 97616 | Germany |
| Praxisklinik Herz Und Gefässe | Dresden | Saxony | 01099 | Germany |
| Heart Center Leipzig, University of Leipzig | Leipzig | Saxony | 04289 | Germany |
| Herz Riesa | Riesa | Saxony | 01587 | Germany |
| Asklepios Klinik St. Georg | Hamburg | 20099 | Germany |
| Heart Center University Hamburg | Hamburg | 20251 | Germany |
| Medizinische Hochschule Hannover, MHH | Hanover | 30159 | Germany |
| Universitätsklinikum Schleswig-Holstein Lübeck | Lübeck | 23562 | Germany |
| Federico II University Hospital | Naples | Campania | 80138 | Italy |
| S Orsola-Malpighi University Hospital | Bologna | Emilia-Romagna | 40138 | Italy |
| Sant'Anna University Hospital of Ferrara | Ferrara | Emilia-Romagna | 44100 | Italy |
| Policlinico di Modena, University of Modena and Reggio Emilia | Modena | Emilia-Romagna | 41100 | Italy |
| Cardiologia Orvieto | Orvieto | Terni | 05018 | Italy |
| University of Florence & AOU Careggi | Florence | Tuscany | 50121 | Italy |
| Clinica Aritmologica, Universita Politecnica delle Marche | Ancona | 60100 | Italy |
| Cardiology Unit Borgo San Lorenzo and Serristori | Florence | Italy |
| Toruń Hospital | Torun | Vistula Rive | 87-100 | Poland |
| District Chojnice Hospital | Chojnice | 89-600 | Poland |
| Scanmed Cardiology Center | Ełk | 19-302. | Poland |
| Centrum Opieki Medycznej w Jaroslawiu | Jarosław | 37-500 | Poland |
| Polikliniką SPZOZ w Lublinie | Lublin | 20-400 | Poland |
| Przasnysz | Przasnysz | 06-300 | Poland |
| Pułtusk | Pułtusk | 06-100 | Poland |
| Siedlce 2 Hospital | Siedlce | 08-119 | Poland |
| Wojewódzki Szpital Specjalistyczny nr 5 im | Sosnowiec | 41-200 | Poland |
| Szpital Wojewodzki in Sw. Lukasza / Regional Specialist Hospital | Tarnów | 33-100 | Poland |
| Wegrow Hospital | Węgrów | 07-100 | Poland |
| Lukow | Łuków | 21-400 | Poland |
| Hospital Universitario Puerta del Mar | Seville | Andalusia | 11009 | Spain |
| Virgen del Rocio University Hospital | Seville | Andalusia | 41013 | Spain |
| Hospital Miguel Servet | Zaragoza | Aragon | 50009 | Spain |
| Hospital Vall d'Hebron | Barcelona | Catalonia | 08035 | Spain |
| Hospital Universitari de Bellvitge | Barcelona | Catalonia | 08907 | Spain |
| Hospital Germans Trias i Pujol | Barcelona | Catalonia | 08916 | Spain |
| Hospital Universitari Doctor Josep Trueta | Girona | Catalonia | 17007 | Spain |
| Hospital General Universitario de Alicante | Alicante | Valencian | 03010 | Spain |
| Hospital Universitario La Paz | Madrid | 28046 | Spain |
| Hospital La Fe.com.Valencianna | Valencia | 46026 | Spain |
| Hospital Gral Vigo, Galicia | Vigo | Spain |
| Buckinghamshire Healthcare NHS Trust - Wycombe Hospital | Buckingham | Buckinghamshire | HP11 2TT | United Kingdom |
| Norwich Hospital | Norwich | East of England | NR1-NR16 | United Kingdom |
| Gloucestershire Royal Hospital | Gloucester | England | GL1 3NN | United Kingdom |
| Homerton Hospital | London | England | E9 6SR | United Kingdom |
| St Bartholomew's Hospital | London | England | EC1A 7BE | United Kingdom |
| Imperial College London Chelsea and Westminster Hospital NHS foundation | London | England | SW10 9NH | United Kingdom |
| James Cook University Hospital | Middlesbrough | England | TS4 3BW | United Kingdom |
| Northampton General Hospital | Northampton | England | NN1 5BD | United Kingdom |
| Royal Berkshire foundation NHS trust | Reading | England | RG1 5AN | United Kingdom |
| York Hospital | York | North Yorkshire | YO31 8H | United Kingdom |
| Horton General Hospital | Banbury | River Cherwell in Oxfordshire | OX16 | United Kingdom |
| Royal Devon and Exeter NHS Foundation Trust | Exeter | West England | 01392 | United Kingdom |
| Queen Elizabeth II | Birmingham | United Kingdom |
| Derived |
| Sterlinski M, Bunting KV, Boriani G, Boveda S, Guasch E, Mont L, Rajappan K, Sommer P, Mehta S, Sun Y, Gale CP, van Deutekom C, Van Gelder IC, Kotecha D; STEEER-AF Trial Team. Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association. Europace. 2024 Jul 2;26(7):euae178. doi: 10.1093/europace/euae178. |
| 36746430 | Derived | Szymanski P, Weidinger F, Lordereau-Richard I, Himmelmann A, Arca M, Chaves J, Lee C, Jonker C, Kotecha D, O'Kelly J, Plueschke K, Rys A, Segec A, Wallentin L, Veltrop R, James S. Real world evidence: Perspectives from a European Society of Cardiology Cardiovascular Round Table with contribution from the European Medicines Agency. Eur Heart J Qual Care Clin Outcomes. 2023 Feb 28;9(2):109-118. doi: 10.1093/ehjqcco/qcad009. |
| 34969173 | Derived | Banerjee A, Pasea L, Chung SC, Direk K, Asselbergs FW, Grobbee DE, Kotecha D, Anker SD, Dyszynski T, Tyl B, Denaxas S, Lumbers RT, Hemingway H. A population-based study of 92 clinically recognized risk factors for heart failure: co-occurrence, prognosis and preventive potential. Eur J Heart Fail. 2022 Mar;24(3):466-480. doi: 10.1002/ejhf.2417. Epub 2022 Jan 26. |
| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D004522 | Educational Status |
| ID | Term |
|---|---|
| D012959 | Socioeconomic Factors |
| D011154 | Population Characteristics |
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