Survey: Doctors believe patients with AF underestimate stroke risk, impact

Many physicians said they believe that patients with atrial fibrillation underestimate their risk for ischemic stroke and the effect of atrial fibrillation-related stroke on their daily lives, according to the results of a new survey.

The survey was issued by the Heart Rhythm Society and the National Stroke Association in collaboration with Boehringer Ingelheim. It included responses from more than 1,200 physicians, patients with AF and their caregivers.

According to the results, 90% of physicians believe their patients with AF underestimate the effect of AF-related stroke on their daily lives, and 79% of physicians believe their patients with AF are in denial about their risk for ischemic stroke.

Among patients, two-thirds said they were not previously aware that AF-related strokes are nearly twice as likely to be fatal compared with other strokes.

Among stroke survivors, 61% did not know they had AF before having a stroke. Among patients with AF who have not had a stroke, 32% do not believe they could describe the most common symptoms of stroke.

David Frankel

“The survey results clearly demonstrate room for improvement when it comes to doctor–patient conversations about [AF] and stroke,” David Frankel, MD, FHRS, assistant professor of medicine at the Hospital of the University of Pennsylvania and chair of the HRS AF-Impact of Stroke Survey Working Group, said in a press release. “We hope our study will not only help raise awareness about the increased risk and severity of [AF]-related stroke, but also encourage smart, open conversations. With [AF] projected to affect upward of 15 million Americans by 2050, now is the time to break down these barriers and work toward a common understanding between patients and doctors in order to improve quality of care and, ultimately, prevent stroke.”

According to the results, 97% of doctors said AF-related ischemic stroke can have devastating outcomes for patients and caregivers, and 73% of stroke survivors said experiencing a stroke was worse than they could have imagined.

Among caregivers, 86% said they could not have imagined the work it takes to care for a stroke survivor, and 75% said the stroke survivors in their care can no longer drive and need assistance with daily activities.

The survey revealed a perception gap regarding conversations about AF and stroke risk. Although 90% of physicians reported initiating such conversations, 47% of patients said they initiate the conversations, and only 64% of patients recall such a discussion taking place.

Physicians identified the following as the largest barriers to patient education: patient belief that risk for AF-related stroke goes away once symptoms are treated, patient belief that the risks of medications to reduce the risk for AF-related stroke outweigh their benefits, and difficulty for patients to understand explanations.

According to the press release, the HRS and the National Stroke Association have established a working group of independent medical experts to review the findings and help create a roadmap to improve communication barriers; the results of that work are expected to be made public in early 2015.