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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

Gebreyohannes, EA, Salter, S, Chalmers, L, Bereznicki, L ORCID: 0000-0003-3974-3437 and Lee, KJ ORCID: 0000-0003-3022-4868 2020 , 'Non-adherence to thromboprophylaxis guidelines in Atrial fibrillation: a narrative review of the extent of and factors in guideline non-adherence' , American Journal of Cardiovascular Drugs , doi: 10.1007/s40256-020-00457-3.

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Abstract

Atrial 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.

Item Type: Article
Authors/Creators:Gebreyohannes, EA and Salter, S and Chalmers, L and Bereznicki, L and Lee, KJ
Keywords: non-adherence, thromboprophylaxis, atrial fibrillation, review
Journal or Publication Title: American Journal of Cardiovascular Drugs
Publisher: Adis International Ltd.
ISSN: 1175-3277
DOI / ID Number: 10.1007/s40256-020-00457-3
Copyright Information:

Copyright 2020 Springer Nature Switzerland AG

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