One in three AF patients not receiving anticoagulants to manage stroke risk

A third of known AF patients in the UK - over a quarter of a million people - are not receiving recommended anticoagulation treatment, analysis suggests.

A report funded by two leading pharmaceutical companies found that a third of AF patients – equivalent to over 260,000 people – could be at risk of stroke because they were not receiving NICE-recommended treatment.

Analysis of 2016 data showed that 16% of patients were not receiving any treatment, while 14% were only receiving aspirin.

NICE dropped its recommendation of using aspirin alone to treat AF in its 2014 update of AF guidance, after concluding the increased bleeding risk outweighed 'questionable' benefits. It recommended that patients with AF should be given anticoagulants to help curtail their risk of stroke.

But GP leaders warned the profession should not be forced to prescribe treatments, and had to respect patients' own decision whether or not to accept anticoagulants after informing them of the risks and benefits.

Anticoagulation treatment

Dr Andrew Green, chairman of the GPC clinical and prescribing subcommittee, said GPs should assess their patients for stroke risk – but warned that they should not feel compelled to prescribe treatments without involving patients in decisions.

‘It is true that aspirin is not an effective preventive agent against stroke in AF, GPs should be assessing their patients for stroke risk, and offering anticoagulation where appropriate,’ he said.

‘However, this report, funded by the drug companies that would profit from higher rates of anticoagulation, oversimplifies the issues. It is not a GP’s job to ensure all AF patients are on anticoagulants, but to advise them of the possible benefits and risks of treatment, and to respect their decision regarding management.

‘A "the higher the better" approach to quality measures not only unfairly criticises GPs’ care but also has the real danger of pushing GPs into overruling decisions that ought to be the patient’s alone.’

Trudie Lobban, CEO of the AF Association, said: ‘This is a large-scale problem equating to Wembley stadium being filled almost three times over with AF patients receiving no therapy or inappropriate therapy for AF-related stroke prevention.'

The research was funded by Bristol-Myers Squibb and Pfizer.

Photo: iStock

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