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    Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence

    82289.pdf (644.8Kb)
    Access Status
    Open access
    Authors
    Gebreyohannes, Eyob Alemayehu
    Salter, Sandra
    Chalmers, Leanne
    Bereznicki, Luke
    Lee, Kenneth
    Date
    2020
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Gebreyohannes, E.A. and Salter, S. and Chalmers, L. and Bereznicki, L. and Lee, K. 2020. Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence. American Journal of Cardiovascular Drugs. 21: pp. 419–433.
    Source Title
    American Journal of Cardiovascular Drugs
    DOI
    10.1007/s40256-020-00457-3
    Faculty
    Faculty of Health Sciences
    School
    School of Pharmacy and Biomedical Sciences
    Remarks

    This is a post-peer-review, pre-copyedit version of an article published in American Journal of Cardiovascular Drugs. The final authenticated version is available online at: http://doi.org/10.1007/s40256-020-00457-3

    URI
    http://hdl.handle.net/20.500.11937/82247
    Collection
    • Curtin Research Publications
    Abstract

    Atrial fibrillation is the most common arrhythmia. It increases the risk of thromboembolism by up to fivefold. Guidelines provide evidence-based recommendations to effectively mitigate thromboembolic events using oral anticoagulants while minimizing the risk of bleeding. This review focuses on non-adherence to contemporary guidelines and the factors associated with guideline non-adherence. The extent of guideline non-adherence differs according to geographic region, healthcare setting, and risk stratification tools used. Guideline adherence has gradually improved over recent years, but a significant proportion of patients are still not receiving guideline-recommended therapy. Physician-related and patient-related factors (such as patient refusals, bleeding risk, older age, and recurrent falls) also contribute to guideline non-adherence, especially to undertreatment. Quality improvement initiatives that focus on undertreatment, especially in the primary healthcare setting, may help to improve guideline adherence.

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