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Background Worldwide, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults and poses a significant burden to patients, physicians, and healthcare systems. We developed a quality of care score based on the Atrial Fibrillation Better Care pathway recommended by the European Society of Cardiology and the European Heart Rhythm Association guidelines. This is a 14-point score that we have termed the MAGIC score(Management of Atrial Fibrillation in Integrated Care and General Practice). Objective The objective of this pilot study was to develop and test a quality of care score for patients with permanent AF in general practice. Methods An observational cross-sectional pilot study was undertaken. Proportionate sampling was used across 11 practices from the Ireland East practice-based research network. The GPs completed a report form on each patient by undertaking a retrospective chart review. Eleven practices participated with a total of 1855 patients with AF. We received data on 153 patients. Results The main findings were that no patient met all 14 guideline based recommendations. The mean MAGIC score was 11.3. Points were most commonly deducted because the creatinine clearance and HAS-BLED score were not recorded, and the patient was not on the correct dose of oral anti-coagulation. Conclusion This study demonstrates the feasibility of using a quality of care score to measure the quality of AF management in general practice. This scoring system, which is based on internationally recognized quality of care markers, highlights key areas that can be targeted with quality improvement intervention. [ABSTRACT FROM AUTHOR]

Hypercholesterolemia is a well-described risk factor for atherosclerotic cardiovascular disease (ASCVD). Statins remain the cornerstone of therapy. Statin intolerance (SI) particularly statin associated muscle symptoms (SAMS) and inappropriate stopping of treatment is associated with increased cardiovascular risk. A significant proportion of reported SAMS relates to expectation of side effects and can be termed the 'negative drucebo effect'. Patients should be educated about SI, the negative drucebo effect, in addition to the benefits of adherence to the therapy when first prescribed a statin. The aim of this commentary is to discuss the issue of statin intolerance, the negative drucebo effect and to suggest some interventions that may be used to address this issue., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Competing Interests: Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: none. Further details of The BMJ policy on financial interests is here: https://www.bmj.com/sites/default/files/attachments/resources/2016/03/16-current-bmj-education-coi-form.pdf