Management of Stroke Prevention in Canadian Patients with Atrial Fibrillation at Moderate to High Risk of Stroke

Semchuk, William; Levac, B.; Lara, Muria; Shakespeare, Annabelle; Evers, Thomas; Bolt, Jennifer

doi:10.4212/cjhp.v66i5.1286

Cited by 2 publications

(3 citation statements)

References 37 publications

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“…This finding is consistent with previous literature reporting AF patients at high risk of stroke to not be receiving AC therapies. 20 We also found that younger patients (≤64 years) and older patients (≥80 years) were less likely to be receiving AC treatment relative to patients 65–79 years of age.…”

Section: Discussionsupporting

confidence: 53%

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Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

Crivera

Nelson

Schein

et al. 2016

PPA

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BackgroundAtrial fibrillation (AF) is associated with an increased risk of stroke. Anticoagulant (AC) therapies are effective at treating AF, but carry with them an increased risk of bleed. Research suggests that a large proportion of AF patients who have high risk of stroke and low risk of bleeding are not currently receiving AC treatment. The goal of this study was to understand the reasons why these patients do not engage in this potentially life-saving treatment.MethodThrough a self-report online survey, using validated instruments, 1,184 US adults who self-reported a diagnosis of AF were screened for the risk of stroke and bleed. Of these patients, 230 (19.4%) were at high risk of stroke, low risk of bleed, and not currently using an AC treatment, and were asked follow-up questions to assess their reasons for nontreatment, attitudes toward treatment, and attitudes toward dosing regimens.ResultsThe most common reasons patients stopped AC treatment were concerns regarding bleeding (27.8%) and other medical concerns (26.6%), whereas the most common reason cited for not being prescribed an AC in the first place was the use of antiplatelet therapy as an alternative (57.1%). In both cases, potentially erroneous decisions regarding perceived stoke and/or bleeding risk were also a factor. Finally, the largest factors regarding attitudes toward treatment and dosing regimen were instructions from an authority figure (eg, physician, pharmacist) and ease of use, respectively.ConclusionResults suggest that many AF patients who are at high risk of stroke but at low risk of bleed may not be receiving AC due to potentially inaccurate beliefs about risk. This study also found that AF patients place trust in physicians above other factors such as cost when making treatment decisions. Increased education of patients by physicians on the risks and benefits may be a simple strategy to improve outcomes.

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Section: Discussionsupporting

confidence: 53%

“…Our findings are consistent with literature citing medical reasons as common reasons for not initiating, or discontinuing, AC medication use. 20 However, previous studies did not delineate the reasons for nonuse of AC treatments that are related to patient beliefs or knowledge, or degree of medication expense or convenience.…”

Section: Discussionmentioning

confidence: 98%

Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

Crivera

Nelson

Schein

et al. 2016

PPA

View full text Add to dashboard Cite

show abstract

“…In the medium-risk group [26][27][28]: A yellow warning was placed at the bedside of patients, and the patients were given routine oxygen inhalation for 3-4 days. Patients received "one-to-one" communications, asked about the source of their negative emotions, and patiently guided through negative emotions to improve their confidence in treatment.…”

Section: Methodsmentioning

confidence: 99%

Application Effect of Multi-Dimension Nursing Combined with GRACE Scoring System in Patients with Atrial Fibrillation after Green Precision Catheter Radiofrequency Ablation

Duan,

Baojun Ren

2023

HSF

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Objective: To explore the application effect of multi-dimensional nursing combined with the Global Registry of Acute Events (GRACE) scoring system in the nursing of patients with atrial fibrillation after radiofrequency ablation with green precision catheter radiofrequency ablation. Methods: A total of 274 patients diagnosed with atrial fibrillation undergoing green precision catheter radiofrequency ablation were collected from the Department of Cardiology at our hospital in a retrospective study. After the inclusion, exclusion, diagnostic criteria and physical examination, all the subjects underwent green precision catheter radiofrequency ablation. According to various nursing methods that were adopted, they were divided into two groups with 7–14 days of nursing intervention by digital randomization: the study group (multi-dimensional nursing combined with GRACE scoring system evaluation, n = 136 cases) and the control group (postoperative routine nursing, n = 138 cases). The MOS item short from health survey (SF-36) score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, complication rates and the nursing quality of the two groups were observed. Results: After multi-dimensional nursing combined with the GRACE in-hospital scoring system for stratified nursing in the study group, SF-36 scores in both groups increased after conventional nursing in the control group, but there was a statistical difference between the study group and the control group (p < 0.05). HAMA score and HAMD score decreased, and there were statistical differences between the study group and the control group (p < 0.05). The comparison between the study group and the control group showed that “Cardiac tamponade”, “Atrioventricular block”, “Peripheral vascular injury” and the total incidence of complications were statistically different (p < 0.05). The basic satisfaction, number of satisfaction and total satisfaction rate of the study group were higher than those of the control group, and the difference was statistically significant (p < 0.05). Conclusions: Multi-dimensional nursing combined with the GRACE scoring system in the nursing care of patients with atrial fibrillation after radiofrequency ablation with the green precision catheter, improves the quality of life, alleviates negative emotions, reduces the incidence of complications, and results in better quality of nursing care.

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Management of Stroke Prevention in Canadian Patients with Atrial Fibrillation at Moderate to High Risk of Stroke

Abstract: Background: Many patients with atrial fibrillation who are at moderate to high risk of stroke do not receive anticoagulation with vitamin K antagonists (VKAs) in accordance with recommendations.

Cited by 2 publications

References 37 publications

Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

Application Effect of Multi-Dimension Nursing Combined with GRACE Scoring System in Patients with Atrial Fibrillation after Green Precision Catheter Radiofrequency Ablation

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