Current clinical practice
The quality of both anticoagulation treatment and services are important parts of care for patients with AF. Sub-standards in either of these areas may lead to consequences including adverse events, non-adherence, long waiting times and poor patient experience.
Research has shown that almost 38,000 warfarin patients are receiving suboptimal anticoagulation in England alone, and that approximately 62% of NHS Trusts have no written clinical protocols in place for reassessing anticoagulation in AF patients with poor anticoagulation control.1
Striving to 'Perfect'
The Perfect domain of Detect, Protect, Perfect aims to promote quality anticoagulation treatment and services to ensure all patients experience best practice care and have optimal protection from AF-related stroke. Opportunities for improvement that may be implemented in primary care practice include:3
- Supporting patients in the correct use of their anticoagulation treatment, enabling them to self-manage and self-monitor
- Providing patient education
- Promoting adherence to anticoagulation therapy
- Having clear protocols to optimise the quality of anticoagulation control
- Using key performance indicators such as referral times, time in therapeutic range (TTR), adverse events
- Regular service reviews
Click here to view ELIQUIS prescribing and adverse event reporting information.
AF = Atrial Fibrillation NOAC = Non-VKA Oral Anticoagulant TTR = Time in Therapeutic Range VKA = Vitamin K Antagonist
- Anticoagulation UK. Out of range: audit of anticoagulation management in secondary care in England. May 2018. Accessed May 2019. Available at: http://www.anticoagulationuk.org/news/2018-05-14-anticoagulation-uk-is-pleased-to-publish-a-new-report-out-of-range-audit-of-anticoagulation-management-in-secondary-care-in-england.
- Imperial College Health Partners. AF Budget Impact Model. Accessed May 2019. Available at: https://imperialcollegehealthpartners.com/af-budget-impact-model/.
- London Clinical Networks. AF Toolkit: Detect, Protect, Perfect. Accessed May 2019. Available at: www.londonscn.nhs.uk/wp-content/uploads/2017/06/detect-protect-perfect-london-af-toolkit-062017.pdf.
Job code: 432UK1900440-01
Date of Prep: May 2019