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Non-adherence to thromboprophylaxis guidelines in Atrial fibrillation: a narrative review of the extent of and factors in guideline non-adherence
journal contribution
posted on 2023-05-20, 21:22 authored by Gebreyohannes, EA, Salter, S, Chalmers, L, Luke BereznickiLuke Bereznicki, Kenneth LeeKenneth LeeAtrial fibrillation is the most common arrhythmia. It increases the risk of thromboembolism by up to fivefold. Guidelines provide evidence-based recommendations to effectively mitigate thromboembolic events using oral anticoagulants while minimizing the risk of bleeding. This review focuses on non-adherence to contemporary guidelines and the factors associated with guideline non-adherence. The extent of guideline non-adherence differs according to geographic region, healthcare setting, and risk stratification tools used. Guideline adherence has gradually improved over recent years, but a significant proportion of patients are still not receiving guideline-recommended therapy. Physician-related and patient-related factors (such as patient refusals, bleeding risk, older age, and recurrent falls) also contribute to guideline non-adherence, especially to undertreatment. Quality improvement initiatives that focus on undertreatment, especially in the primary healthcare setting, may help to improve guideline adherence.
History
Publication title
American Journal of Cardiovascular DrugsISSN
1175-3277Department/School
School of Pharmacy and PharmacologyPublisher
Adis International Ltd.Place of publication
New ZealandRights statement
Copyright 2020 Springer Nature Switzerland AGRepository Status
- Restricted