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Current management of atrial fibrillation: an observational study in NHS primary care

OBJECTIVE: To describe National Health Service (NHS) resource use and pharmacological management of atrial fibrillation (AF) in routine UK primary care. DESIGN: Multicentre retrospective study. SETTING: Seven primary care practices in England, one in Wales. PATIENTS: Patients with AF were identified...

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Autores principales: Kassianos, George, Arden, Chris, Hogan, Simon, Dew, Robert, Fuat, Ahmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840336/
https://www.ncbi.nlm.nih.gov/pubmed/24271019
http://dx.doi.org/10.1136/bmjopen-2013-003004
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author Kassianos, George
Arden, Chris
Hogan, Simon
Dew, Robert
Fuat, Ahmet
author_facet Kassianos, George
Arden, Chris
Hogan, Simon
Dew, Robert
Fuat, Ahmet
author_sort Kassianos, George
collection PubMed
description OBJECTIVE: To describe National Health Service (NHS) resource use and pharmacological management of atrial fibrillation (AF) in routine UK primary care. DESIGN: Multicentre retrospective study. SETTING: Seven primary care practices in England, one in Wales. PATIENTS: Patients with AF were identified and approached for consent. Data were collected on the first 12 weeks post-diagnosis (‘initiation’) and, for established patients, up to the most recent 3 years of management (‘maintenance’). RESULTS: Data collected on 825 patients with AF, 56% men. Mean age (at diagnosis) 70.5 years. Mean 2.4 (SD 2.2) visits to primary care per patient during the initiation phase; 1.5 (SD 1.8) per patient-year during the maintenance phase. Mean 0.4 (SD 0.6) inpatient admissions for AF per patient during the initiation phase and 0.1 (SD 0.3) per patient-year during the maintenance phase. The mean length of hospital stay per admitted patient was 5.6 days during initiation and 6.4 days per patient-year during maintenance. During the initiation phase, 46.1% (143/310) patients received a β-blocker and 97 (31.3%) received no rate/rhythm control. Only 234 (75.5%) patients received thromboprophylaxis in the 12 weeks postdiagnosis and 674 (87.7%) in the maintenance phase. 440 (57.2%) patients were deemed to be at high risk of stroke at the end of the maintenance phase; 55% (242/440) of these were receiving appropriate anticoagulation therapy. CONCLUSIONS: The results suggest that there are opportunities for optimisation of treatment and there is significant NHS resource associated with AF management, the details of which are invaluable for future healthcare planning and policy development in this area.
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spelling pubmed-38403362013-11-26 Current management of atrial fibrillation: an observational study in NHS primary care Kassianos, George Arden, Chris Hogan, Simon Dew, Robert Fuat, Ahmet BMJ Open Cardiovascular Medicine OBJECTIVE: To describe National Health Service (NHS) resource use and pharmacological management of atrial fibrillation (AF) in routine UK primary care. DESIGN: Multicentre retrospective study. SETTING: Seven primary care practices in England, one in Wales. PATIENTS: Patients with AF were identified and approached for consent. Data were collected on the first 12 weeks post-diagnosis (‘initiation’) and, for established patients, up to the most recent 3 years of management (‘maintenance’). RESULTS: Data collected on 825 patients with AF, 56% men. Mean age (at diagnosis) 70.5 years. Mean 2.4 (SD 2.2) visits to primary care per patient during the initiation phase; 1.5 (SD 1.8) per patient-year during the maintenance phase. Mean 0.4 (SD 0.6) inpatient admissions for AF per patient during the initiation phase and 0.1 (SD 0.3) per patient-year during the maintenance phase. The mean length of hospital stay per admitted patient was 5.6 days during initiation and 6.4 days per patient-year during maintenance. During the initiation phase, 46.1% (143/310) patients received a β-blocker and 97 (31.3%) received no rate/rhythm control. Only 234 (75.5%) patients received thromboprophylaxis in the 12 weeks postdiagnosis and 674 (87.7%) in the maintenance phase. 440 (57.2%) patients were deemed to be at high risk of stroke at the end of the maintenance phase; 55% (242/440) of these were receiving appropriate anticoagulation therapy. CONCLUSIONS: The results suggest that there are opportunities for optimisation of treatment and there is significant NHS resource associated with AF management, the details of which are invaluable for future healthcare planning and policy development in this area. BMJ Publishing Group 2013-11-22 /pmc/articles/PMC3840336/ /pubmed/24271019 http://dx.doi.org/10.1136/bmjopen-2013-003004 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Cardiovascular Medicine
Kassianos, George
Arden, Chris
Hogan, Simon
Dew, Robert
Fuat, Ahmet
Current management of atrial fibrillation: an observational study in NHS primary care
title Current management of atrial fibrillation: an observational study in NHS primary care
title_full Current management of atrial fibrillation: an observational study in NHS primary care
title_fullStr Current management of atrial fibrillation: an observational study in NHS primary care
title_full_unstemmed Current management of atrial fibrillation: an observational study in NHS primary care
title_short Current management of atrial fibrillation: an observational study in NHS primary care
title_sort current management of atrial fibrillation: an observational study in nhs primary care
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840336/
https://www.ncbi.nlm.nih.gov/pubmed/24271019
http://dx.doi.org/10.1136/bmjopen-2013-003004
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