According to a study by Duke University, North Carolina, USA, an educational program for patients with atrial fibrillation and their healthcare providers did not result in more oral anticoagulants being administered in one year than with the usual treatment.1
IMPACT-AFib is an intervention study. Prof. Sean Pokorney's team investigated whether early education about stroke prevention in atrial fibrillation increases the use of oral anticoagulants by patients and their healthcare workers.
A total of 47,333 patients (mean age: 78 years) with atrial fibrillation and an indication for oral anticoagulation (CHA₂DS₂-VASc-Score from ≥2) participated in the study. They were randomly assigned either an early intervention (i.e. a mailing at the beginning of the study) or a delayed intervention (i.e. the standard care).
Participants were not prescribed anticoagulants for the previous 12 months and were not treated for bleeding in the previous six months. Of the patients who started taking oral anticoagulants during the 12-month follow-up period, 9.89 percent were in the intervention group and 9.8 percent in the usual care group.
Most respondents took oral anticoagulants immediately after the mailing. Could multiple mailings or further contacts, therefore, be an advantage? Additional studies would be needed to assess the feasibility of patient consent and the repetition of patient interactions.
1. Pokorney S.: IMPACT-AFib. Implementation of Stroke Prevention in Atrial Fibrillation. Hot Line 4 Session, ESC Congress, 31 August 2020