Experts unveil tools to improve AF care

The American College of Physicians Foundation announced new interventions designed to enhance the management of atrial fibrillation and related stroke prevention this week at the foundation’s Initiative on Atrial Fibrillation and Stroke Prevention in Washington, D.C. The goal of the interventions is to close gaps in practice by improving the understanding of treatment options and related risks and benefits among health care providers, patients and their caregivers.

“When patients are empowered and educated they are more likely to speak with their practitioners and more likely to ask questions and understand decisions that must be made in their own health care. We also know that with more education they are more likely to adhere to whatever decisions they have made with their clinicians,” Doron Schneider, MD, FACP, medical director of the Center for Patient Safety and Healthcare Quality, said at a press briefing. “These comprehensive [initiatives] help accomplish all of that.”

Four interventions

The interventions include:

A booklet, “Afib: What you and your Family Need to Know,” designed to enhance provider–patient communication around AF and empower patients and families with the knowledge to reduce stroke risk and live well with AF.
Three educational videos on living with AF; safe and effective discharge from the hospital; and medications to reduce risk for stroke.
“A Guide for the Quality Improvement Professional and Health System Leadership,” a compendium of information and tools to create awareness of the impact of poor management of AF within health systems.
“Background Information and Anticoagulation Decision Support,” to be distributed to clinicians to improve clinician knowledge, skills and attitudes around AF and stroke risk reduction and to assist in anticoagulation decision-making.

The interventions were designed to be engaging, Schneider said. Initial research showed that 94% of patients who experienced a stroke or mini-stroke [TIA] found the information in the booklet helpful, clearly written and easy to understand. Patients reported that 76% of the time, the guide helped them understand specific risks for stroke and AF and how to prevent and treat the risks. Additionally, 65% of patients reporting feeling more confident in their ability to talk to health care providers about AF medications and personal care, according to information in a press release.

“We know through former studies that much of our population is health illiterate,” said Barbara Schuster, MD, MACP, co-chair of the Afib Initiative National Steering Committee and chair of the American College of Physicians (ACP) Foundation board of trustees. “By making health literate interventions, we can help create conversation between the patient and their clinician.”

Cause-and-effect relationship

According to Samuel Goldhaber, MD, professor of medicine at the Harvard Medical School and director of the Brigham and Women’s Hospital Venous Thromboembolism Research Group, 2 million to 3 million people are affected by AF. By 2050, that number is projected to rise to 12 million to 16 million.

Trials such as RE-LY and ROCKET AF have shown that oral anticoagulants have a better effect on patients with AF vs. warfarin. Goldhaber said the oral anticoagulants will provide more choices for patients, more convenience and less intracranial hemorrhage.

“You don’t need to be a specialist to prevent a stroke from AF. The family physician, the nurse practitioner, the physician’s assistant, the general internal medicine physician are all going to be preventing stroke, looking for AF, knowing what the CHADS risk score is for developing a stroke and then selecting an agent [to help prevent stroke],” Goldhaber said at the press briefing. “The ACP is allowing us, through its new tool kit, to empower patients to discuss the options of stroke prevention of AF with their clinicians.”

The intervention booklet and videos are available to download on the ACP Foundation website. Tools will be available in electronic and paper format to suit the various needs of patients and clinicians in the United States.

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