Prevalence of atrial fibrillation and eligibility for anticoagulants in the community

Sudlow, Mark; Thomson, Richard; Thwaites, Barnaby; Rodgers, Helen; Kenny, Rose Anne

doi:10.1016/s0140-6736(98)01401-9

Cited by 338 publications

(237 citation statements)

References 24 publications

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“…On the other hand, AF patients in general medical practice are, on average, older than participants in this cohort, and consequently the fraction at high risk may be larger. 20 The effect of aspirin therapy on stroke rates in this cohort cannot be determined in the absence of an untreated, randomized control group. In pooled analysis of randomized trials in AF, aspirin has been associated with a 20% reduction in stroke.…”

Section: Discussionmentioning

confidence: 93%

Factors Associated With Ischemic Stroke During Aspirin Therapy in Atrial Fibrillation

Hart

Pearce²,

McBride³

et al. 1999

Stroke

460

125

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on behalf of the Stroke Prevention in Atrial Fibrillation (SPAF) InvestigatorsBackground and Purpose-Nonvalvular atrial fibrillation (AF) is a strong, independent risk factor for stroke, but the absolute rate of stroke varies widely among AF patients, importantly influencing the potential benefit of antithrombotic prophylaxis. We explore factors associated with ischemic stroke in AF patients taking aspirin. Methods-We performed multivariate logistic regression analysis of 2012 participants given aspirin alone or in combination with low, inefficacious doses of warfarin in the Stroke Prevention in Atrial Fibrillation I-III trials followed for a mean of 2.0 years, during which 130 ischemic strokes were observed. Pϭ0.007). With the use of these variables, a risk stratification scheme for primary prevention separated participants into those with high (7.1%/y, 22% of the cohort), moderate (2.6%/y, 37% of the cohort), and low (0.9%/y, 41% of the cohort) rates of stroke. Ischemic strokes in low-risk participants were less often disabling (PϽ0.001). Conclusions-Patients with AF who have high and low rates of stroke during treatment with aspirin can be identified.However, validation of our risk stratification scheme is necessary before it can be applied with confidence to clinical management. Postmenopausal estrogen replacement therapy and moderate alcohol consumption may additionally modify the risk of stroke in AF, but these findings require confirmation. (Stroke. 1999;30:1223-1229.)

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Section: Discussionmentioning

confidence: 93%

Factors Associated With Ischemic Stroke During Aspirin Therapy in Atrial Fibrillation

Hart

Pearce²,

McBride³

et al. 1999

Stroke

460

125

View full text Add to dashboard Cite

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“…9,11 Wide concern has been expressed that when such criteria are used, atrial fibrillation is being undertreated in elderly people. 2,3,19 Our results suggest that treatment choice among elderly people is more complex than simply applying absolute risk standards of treatment. Factors relating to individual patients have been described and attributed as one of the reasons for the poor incorporation of anticoagulation treatment in clinical practice.…”

Section: Comparison With Guidelinesmentioning

confidence: 86%

“…1 Community-based studies that estimated the prevalence of atrial fibrillation, however, show underdiagnosis and undertreatment. 2,3 Commentators from general practice attribute the poor incorporation of this treatment in clinical practice to a lack of representativeness of patients enrolled in clinical trials. In particular, patients managed in primary care may be more likely than patients in clinical trials to find "minor" side effects from anticoagulation problematic.…”

mentioning

confidence: 99%

Effects of patients' preferences on the treatment of atrial fibrillation: observational study of patient-based decision analysis

Protheroe

Fahey²,

Montgomery³

et al. 2001

Western Journal of Medicine

103

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“…[20] Patients on usual long-term oral anticoagulant care, in PHC and GP setting, are mostly older people with the diagnosis of FA, or with conditions which predispose them to deep venous thromboembolism. [33,34] Characteristics of patients with FA are that they usually possess one or more risk factors for thromboembolic stroke and at the same time have increased risk for bleeding. In this context, FA typically occurs on the basis of chronic heart failure, the main risk factors for which include: older age, hypertension, diabetes and atherosclerotic artery disease.…”

Section: Cds Program For a Long-term Oral Anticoagulant Therapy Survementioning

confidence: 99%

A methodology pathway to develop a Computer Drug Safety program in Primary health care setting based on clinical audit

Trtica

Guljaš

Šabanović

2015

JHA

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Objective: Medications management is an area in Primary health care (PHC) and General Practice (GP) setting where decision making is very important. Computer Decision Support program have been developed to help primary physicians in their decisions and have proved effective in improving the process of care and promising in economic issues. Methods: In order to create a Computer Drug Safety (CDS) program for managing oral anticoagulant therapy for use in PHC and GP setting with developed Information Technology (IT) System and established electronic Health Records (eHRs), we used clinical audit (a real-life practice analysis) as the methodology framework. We assumed that this method would enable a proposed CDS program to cope with clinical complexity of GP patients taking oral anticoagulants and also suggest this method as the operative framework for Quality of Care (QC) improvement and practice research. Results: By using clinical audit, we were able to identify the list of elements necessary for building up a feasible CDS program for a long-term oral anticoagulant therapy surveillance, for use in PHC and GP setting. According to this list of elements, we were able to create a paper based concept (a schemata) for this program development. This CDS program would not be a simple drug-dose calculator, but a comprehensive software support system integrated within the existing IT work applications. Conclusions: The main benefits, expected from this proposed CDS program, include: learning from work experience, oral anticoagulant QC improvement, better patients compliance to long-term treatment with the drug warfarin, practice performance follow up and practice research.

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Prevalence of atrial fibrillation and eligibility for anticoagulants in the community

Cited by 338 publications

References 24 publications

Factors Associated With Ischemic Stroke During Aspirin Therapy in Atrial Fibrillation

Factors Associated With Ischemic Stroke During Aspirin Therapy in Atrial Fibrillation

Effects of patients' preferences on the treatment of atrial fibrillation: observational study of patient-based decision analysis

A methodology pathway to develop a Computer Drug Safety program in Primary health care setting based on clinical audit

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