Utilisation of antithrombotic therapy for stroke prevention in atrial fibrillation in a Sydney hospital: Then and now

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dc.contributor.author Bajorek, BV
dc.contributor.author Ren, S
dc.date.accessioned 2012-10-12T03:34:15Z
dc.date.issued 2012-02
dc.identifier.citation International Journal of Clinical Pharmacy, 2012, 34 (1), pp. 88 - 97
dc.identifier.issn 2210-7703
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/18474
dc.description.abstract Objective Evidence from pivotal clinical trials conducted more than a decade ago supports the use of antithrombotic therapy, particularly warfarin, for stroke prevention in atrial fibrillation (AF). Despite the wide dissemination of this evidence since that time, there is anecdotal evidence that utilisation of therapy remains suboptimal, especially in the target elderly population, which is reflected in the development of practice tools such as the TAG Clinical Indicator ('Antithrombotics in AF' Indicator 1.6, 2007). Therefore, the objective of this study was to determine the current utilisation of antithrombotic therapy for elderly patients with AF in the local setting, and to compare this utilisation with the results of a prior audit (AUDIT 1), as well as against the recommendations of the TAG Clinical Indicator (TAG IND). Setting A major teaching hospital in Sydney, Australia. Method A retrospective audit (AUDIT 2) of medical records of hospital inpatients (aged 65 years, with a significant diagnosis of AF), pertaining to admissions over the 12-month period 1st June 2006-31st May 2007, was conducted. Main outcome measure Proportion of patients receiving antithrombotic therapy at the point of discharge from hospital. Results A total of 201 patients (mean age 79.8 ± 7.8 years) were reviewed in AUDIT 2. Most (85%) patients received antithrombotic therapy (vs. 79.2%, AUDIT 1), with "warfarin ± antiplatelets" most frequently (46.3%) used (vs. 34.5%, AUDIT 1), followed by "aspirin ± other antiplatelet" (33.3% AUDIT 2 vs. 43.1% AUDIT 1). Patients aged 80 years were significantly less likely to receive warfarin therapy, compared to those <80 years (40.2% vs. 52.5%, P = 0.01). Of those patients who were deemed 'eligible' for warfarin according to AUDIT 2 (n = 155), only 55.0% of patients were actually prescribed this treatment. Results obtained by AUDIT 2 and TAG IND were overall comparable. Conclusion Whilst there have been temporal improvements in the overall utilisation of antithrombotic therapy, including warfarin, there are still significant gaps in the translation of evidence from clinical trials to clinical practice. Further sustainable intervention is warranted to help apply treatment recommendations to the target population. © 2011 CARS.
dc.language eng
dc.relation.isbasedon 10.1007/s11096-011-9594-y
dc.title Utilisation of antithrombotic therapy for stroke prevention in atrial fibrillation in a Sydney hospital: Then and now
dc.type Journal Article
dc.parent International Journal of Clinical Pharmacy
dc.journal.volume 1
dc.journal.volume 34
dc.journal.number en_US
dc.publocation Netherlands en_US
dc.publocation USA
dc.identifier.startpage 88 en_US
dc.identifier.endpage 97 en_US
dc.cauo.name GSH.Pharmacy en_US
dc.conference Verified OK en_US
dc.conference ACM Conference on Information and Knowledge Management
dc.for 1115 Pharmacology and Pharmaceutical Sciences
dc.personcode 112624
dc.percentage 100 en_US
dc.classification.name Pharmacology and Pharmaceutical Sciences en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.date.activity 2012-10-29
dc.location.activity en_US
dc.location.activity Hawaii, USA
dc.description.keywords Drug therapy; Stroke; Cardiac arrhythmia; Pharmacology; Clinical outcomes en_US
dc.description.keywords NA
dc.description.keywords Drug therapy
dc.description.keywords Drug therapy
dc.description.keywords Drug therapy
dc.description.keywords Stroke
dc.description.keywords Stroke
dc.description.keywords Stroke
dc.description.keywords Stroke
dc.description.keywords Cardiac arrhythmia
dc.description.keywords Cardiac arrhythmia
dc.description.keywords Cardiac arrhythmia
dc.description.keywords Cardiac arrhythmia
dc.description.keywords Pharmacology
dc.description.keywords Pharmacology
dc.description.keywords Pharmacology
dc.description.keywords Pharmacology
dc.description.keywords Clinical outcomes
dc.description.keywords Clinical outcomes
dc.description.keywords Clinical outcomes
dc.description.keywords Clinical outcomes
dc.description.keywords Aged care
dc.description.keywords Aged care
dc.description.keywords Antithrombotic agents
dc.description.keywords Antithrombotic agents
dc.description.keywords Aspirin
dc.description.keywords Aspirin
dc.description.keywords Atrial fibrillation
dc.description.keywords Atrial fibrillation
dc.description.keywords Australia
dc.description.keywords Australia
dc.description.keywords Clinical indicator
dc.description.keywords Clinical indicator
dc.description.keywords Drug utilisation
dc.description.keywords Drug utilisation
dc.description.keywords Elderly
dc.description.keywords Elderly
dc.description.keywords Stroke
dc.description.keywords Stroke
dc.description.keywords Stroke prevention
dc.description.keywords Stroke prevention
dc.description.keywords Warfarin
dc.description.keywords Warfarin
dc.description.keywords Aged care
dc.description.keywords Antithrombotic agents
dc.description.keywords Aspirin
dc.description.keywords Atrial fibrillation
dc.description.keywords Australia
dc.description.keywords Clinical indicator
dc.description.keywords Drug utilisation
dc.description.keywords Elderly
dc.description.keywords Stroke
dc.description.keywords Stroke prevention
dc.description.keywords Warfarin
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Graduate School of Health
pubs.organisational-group /University of Technology Sydney/Strength - Health Services and Practice Research


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