Encouraging Dialogue: Complications in Heart Rhythm Cases.

Call for Heart Rhythm Patients and Doctors to Talk More to Prevent Stroke or Bleeding Complications

Survey suggests that, for people living with atrial fibrillation (AF), NICE guidelines need to be implemented more consistently
-In the UK, AF affects around 1 in 10 people aged 65 years of age and over

A new survey suggests that, contrary to national guidelines, the majority (63%) of people with atrial fibrillation (AF) prescribed anticoagulants, a type of medication that helps prevent blood clots, were not given a choice of which anticoagulant they would receive. As many as 1 in 5 (20%) stated they were not made aware by their healthcare professional of their increased risk of an AF-related stroke, or steps they should take to help reduce their risk.

The survey of over 200 patients was conducted by the Bristol-Myers Squibb/Pfizer Collaboration and AF Turnaround, a partnership of leading medical experts and professional patient associations who are focused on preventing AF-related stroke by encouraging the adoption of national clinical guidelines for managing AF.   The survey suggests that implementation of the guidelines can be further improved to ensure consistency regarding the aspect of patient involvement in decision making. Implementing the NICE Guidelines (CG180) may result in 10,000 fewer AF-related strokes per year, according to NHS estimates, through interventions such as increasing anticoagulation therapy which helps reduce the risk of blood clots, and by helping people with AF to better manage their condition.

“One of the key recommendations introduced by NICE five years ago to involve patients in decision making to reduce their risk of an AF-related stroke may not be happening consistently. It is known that AF is a leading cause of stroke and that AF-related strokes can be more devastating and debilitating than any other type of stroke. 20% of strokes are due to AF and yet medication exists to prevent them – it is troubling that more is not being done,” said Trudie Lobban MBE, Founder & CEO of AF Association and Arrhythmia Alliance, Co-Chair of AF Turnaround.

Identifying and prescribing anticoagulation therapy to reduce the risk of AF-related stroke is a key priority area set out in the NHS’ Long Term Plan.  Launched in January 2019, the plan has a strong focus on improving prevention and detection of the risk factors associated with stroke as part of its ambitions to improve the quality of patient care and health outcomes for NHS users.

“Educating patients about AF and involving them in decisions about their anticoagulant therapy should be a key priority area in how healthcare professionals deliver a personalised package of care in the current guidelines.  Anyone with AF who has been prescribed anticoagulants should be having a conversation with their doctor about the anticoagulant therapy options available to them in order to help reduce their risk of an AF-related stroke or bleeding” said Eve Knight, Chief Executive and Cofounder of Anticoagulation UK and Co-Chair of AF Turnaround.

“Anticoagulants are effective at reducing the risk of an AF-related stroke, but it’s crucial that patients are properly assessed and supported in their decision as regards prevention of AF-related stroke,” said Dr Matt Fay, GP and member of the AF Turnaround Steering Committee. “It’s encouraging however that the survey showed that the vast majority of patients are being prescribed effective, preventative treatments to reduce their risk of having an AF-related stroke.”

Out of those who took part in the survey, 49% said they would like more involvement in the choice of anticoagulation therapy and 53% did not recall having any discussion with their healthcare professional about the choice of anticoagulants available to them.  The survey also found that, contrary to national guidelines, 1 in 6 (16%) people said that they had not had their anticoagulation therapy reviewed in the previous 12 months.1

According to national guidelines on the care people living with AF should expect to receive, all anticoagulant drugs should be reviewed on a regular basis depending on the type of anticoagulation prescribed.