Identification and early anticoagulation in patients with atrial fibrillation in the emergency department

Effectiveness of an algorithm‐based care pathway for patients with non‐valvular atrial fibrillation presenting to the emergency department

“…Use of the EDAFMP was associated with substantial increases in the performance of an established AF quality metric (appropriately prescribing anticoagulation) 35 and referral for post-ED discharge cardiac specialty care, which has also been associated with better adherence to AF clinical measures. 36 The improvement in these care process measures we observed was similar to previous reports, 16,32,34 although different in degree as the preimplementation group had low baseline performance. We attribute the increases to decision support, specific orderable items, and structured documentation embedded into the EDAFMP that facilitated delivery of these interventions.…”

“…Previous studies have also assessed the relationship of AF care pathways with the other hospital use outcomes we measured. 16,32,34 In accord with these studies, within the concurrent, postimplementation group we observed no increase in return ED visits or hospital admissions associated with EDAFMP use at 30-,60-, and 90-day intervals.…”

Integrated Care for Atrial Fibrillation Management: The Role of the Pharmacist

“…32,38 Studies included patients on warfarin (n=9), 18-20, 23, 30, 36, 37, 39, 44 non-vitamin K antagonist oral anticoagulants (NOACs) (n=8) 17,27,[31][32][33][34][35]41 or both (n=1). 46 Nine studies referred broadly to anticoagulants, 22,24,25,28,29,38,40,43,45 and three evaluated antithrombotics. 21,26,42 Seven studies reported the quality of warfarin therapy, measured by time in therapeutic range (TTR), 18,20,30,36,37,39,44 seven reported on health outcomes (thromboembolism, bleeding, mortality), 19,27,29,33,35,39,44 15 reported on oral anticoagulant (OAC) prescribing, 21-26, 31, 34, 38, 40, 42, 43, 45, 46 28 one on patient knowledge 32 , one on patient cognition, 17 two on patient satisfaction 17,28 , and three on medication adherence.…”

“…25 Other studies also demonstrated positive effects of other distinct pharmacist-led interventions on increasing OAC prescribing (Table 2). 21,23,26,40,42 Medication adherence, knowledge and patient satisfaction Pharmacist-delivered patient education was a core component of three studies 32,33,41 that reported on patient knowledge 32 and medication adherence (Table 2). 32,33,41 In a before-and-after study of 68 participants taking dabigatran, there was no significant difference in the proportion of participants with a medication possession ratio (number of dispensed doses in a specified time period divided by the total number of days in that time period) ≥80% (Table 2).…”