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Stroke risk assessment for atrial fibrillation: hospital-based stroke risk assessment and intervention program
Citation
Jackson, SL and Peterson, GM, Stroke risk assessment for atrial fibrillation: hospital-based stroke risk assessment and intervention program, Journal of Clinical Pharmacy and Therapeutics, 36, (1) pp. 71-79. ISSN 0269-4727 (2011) [Refereed Article]
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The definitive published version is available online at: http://onlinelibrary.wiley.com/
Official URL: http://onlinelibrary.wiley.com/
DOI: doi:10.1111/j.1365-2710.2009.01156.x
Abstract
Background: Despite the proven effectiveness of antithrombotic therapy for atrial fibrillation (AF), the treatment remains suboptimal. The aim of this study was to implement and evaluate a system to improve the appropriate use of antithrombotics for stroke prevention in AF utilizing a clinical pharmacist as a stroke risk assessor.
Method: Hospital in-patients with AF were prospectively identified and they received a formal stroke risk assessment from a pharmacist. The patients’ risk of stroke was assessed and documented according to Australian guidelines and a recommendation regarding antithrombotic therapy was made to the medical team on a specially designed stroke risk assessment form.
Results: One hundred and thirty-four stroke risk assessments were performed during the intervention period. For those patients at high risk of stroke and with no contraindication present (warfarin-eligible patients), 98% were receiving warfarin on discharge from hospital compared to 74% on admission (P < 0.001). Of the 50 (37%) assessments that recommended a change of therapy, 44 (88%) resulted in a change in the patient’s current antithrombotic therapy compared to their admission therapy. Thirty (68%) of the assessments resulted in an ‘upgrade’ to more-effective treatment options for example from no therapy to any agent or from aspirin to warfarin.
Discussion and Conclusion: The pharmacist-led stroke risk assessment program resulted in a significant increase in the proportion of patients receiving appropriate thromboprophylaxis for stroke prevention in AF. The methods used in this study should be evaluated in a larger trial, in multiple hospitals, with different pharmacists performing the intervention.Item Details
Item Type: | Refereed Article |
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Keywords: | atrial fibrillation, pharmacist, stroke, stroke prevention, warfarin |
Research Division: | Biomedical and Clinical Sciences |
Research Group: | Pharmacology and pharmaceutical sciences |
Research Field: | Clinical pharmacology and therapeutics |
Objective Division: | Health |
Objective Group: | Clinical health |
Objective Field: | Clinical health not elsewhere classified |
UTAS Author: | Jackson, SL (Dr Shane Jackson) |
UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
ID Code: | 66471 |
Year Published: | 2011 |
Web of Science® Times Cited: | 5 |
Deposited By: | Pharmacy |
Deposited On: | 2011-01-27 |
Last Modified: | 2012-10-10 |
Downloads: | 0 |
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