ArticleThe Australasian medical journal2015
Contemporary approaches to managing atrial fibrillation: A survey of Australian general practitioners.
Article in The Australasian medical journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Patients' and clinicians' perceptions of oral anticoagulants in atrial fibrillation: a systematic narrative review and meta-analysis.BMC family practice · 2021Pooled it
- Pooled it
- Non-vitamin k antagonist oral anticoagulants in a European primary care physician survey.BJGP open · 2018Article
- Decision-making around antithrombotics for stroke prevention in atrial fibrillation: the health professionals' views.International journal of clinical pharmacy · 2016Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent attention to the management of atrial fibrillation (AF) and stroke prevention has emphasised the need to support the use of existing pharmacotherapy through available services and resources, in preference to using the new, more expensive, novel oral anticoagulants. In this regard, general practitioners (GPs) are at the core of care.
aimsTo survey Australian GPs regarding their approach to managing AF, particularly in relation to stroke prevention therapy, and to identify the range of services to support patient care.
methodsA structured questionnaire, comprising quantitative and qualitative responses, was administered to participating GPs within four geographical regions of NSW (metropolitan, regional, rural areas).
resultsFifty GPs (mean age 53.74±9.94 years) participated. Most (98 per cent) GPs regarded themselves as primarily responsible for the management of AF, only referring patients to specialists when needed. However, only 10 per cent of GPs specialised in "heart/vascular health". Most (76 per cent) GPs offered point-of-care international normalised ratio (INR) testing, with 90 per cent also offering patient support via practice nurses and home visits. Overall, key determinants influencing GPs' initiation of antithrombotic therapy were: "stroke risk"/"CHADS2 score", followed by "patients' adherence/compliance". GPs focused more on medication safety considerations and the day-to-day management of therapy than on the risk of bleeding.
conclusionAustralian GPs are actively engaged in managing AF, and appear to be well resourced. Importantly, there is a greater focus on the benefits of therapy during decision-making, rather than on the risks. However, medication safety considerations affecting routine management of therapy remain key concerns, with patients' adherence to therapy a major determinant in decision-making.
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