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SHR Neuro Cancer Cardio Lipid Metab Microb
Deplanque, D; Leys, D; Parnetti, L; Schmidt, R; Ferro, J; De Reuck, J; Mas, JL; Gallai, V; SAFE II Investigators.
Stroke prevention and atrial fibrillation: reasons leading to an inappropriate management. Main results of the SAFE II study.
Br J Clin Pharmacol. 2004; 57(6):798-806
Doi: 10.1111/j.1365-2125.2004.02086.x
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- Co-authors Med Uni Graz
- Schmidt Reinhold
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- Abstract:
- AIMS: The aim of the Stroke and Atrial Fibrillation Ensemble (SAFE) II study was to identify the reasons underlying the under-utilization of oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (NVAF). METHODS: We investigated from all available sources the reasons why patients hospitalized for a stroke, who had a previously known NVAF, were not receiving OAC beforehand. We interviewed general practitioners (GPs) and cardiologists with a structured questionnaire, to identify the reasons for their therapeutic choice. RESULTS: Of 370 patients, 257 were theoretically eligible for OAC according to guidelines and the presence of contra-indications, but only 82 (22.2%) of them had actually received OAC before. We found that factors independently associated with the prescription of OAC were being followed-up by a cardiologist and having a younger GP. The leading reason evoked by GPs or cardiologists to explain why patients were not treated with OAC was the presence of a 'potential contra-indication', which was often inappropriate, followed by 'there was no indication', 'low compliance' and 'fear of bleeding'. CONCLUSIONS: An important reason for not prescribing OAC was the lack of knowledge about trials and guidelines. Medical education about OAC in NVAF should therefore be improved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Anticoagulants - therapeutic use
- Atrial Fibrillation - drug therapy
- Cerebrovascular Accident - prevention and control
- Europe - prevention and control
- Guideline Adherence - prevention and control
- Health Services Misuse - statistics and numerical data
- Humans - statistics and numerical data
- Practice Guidelines - statistics and numerical data
- Prospective Studies - statistics and numerical data
- Find related publications in this database (Keywords)
- atrial fibrillation
- misuse
- oral anticoagulation
- prevention
- stroke