Partnering with patients in shared decision making for stroke prevention in atrial fibrillation

SAGE Publications
Publication Type:
Journal Article
European Journal of Cardiovascular Nursing, 2017, 16 (3), pp. 178 - 180
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Atrial fibrillation (AF) is the most common cardiac arrhythmia. The population prevalence of AF ranges from 2.3 to 3.4% and is estimated to double by 2050 as we approach epidemic levels.1 AF is a major, complex and challenging risk factor for stroke. It is estimated that about 20% of all strokes are a consequence of AF. AF-related strokes affect more of the brain, are usually more severe and are associated with greater levels of disability with poorer outcomes.2 Anticoagulation is a well-established pharmacotherapy to reduce the risk of stroke in patients with AF; however, the rates of thromboprophylaxis remain poor,3 with only 60–70% of eligible patients receiving anticoagulation drugs.3 The advent of novel oral anticoagulants, including dabigatran, rivaroxaban, apixaban and edoxaban, has created an increase in the choice of treatment for patients. It is important that patients and caregivers are central to decision-making about anticoagulants. Active patient participation is of the utmost importance in this process and requires education about the risks and benefits of each treatment to inform their decision. Before patients and caregivers are ready to participate in decision-making processes, it is vital that they are comprehensively educated on both their condition and the available therapeutic approaches to stroke prevention in AF.
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