Healthcare resources and needs in anticoagulant therapy for patients with nonvalvular atrial fibrillation. SAMOA Study

作者：Barrios V^*; Egocheaga Cabello M I; Gallego Cullere J; Ignacio Garcia E; Manzano Espinosa L; Martin Martinez A; Mateo Arranz J; Polo Garcia J; Vargas Ortega D

来源：Revista Clinica Espanola, 2017, 217(4): 193-200.

DOI：10.1016/j.rce.2016.12.011

• Anticoagulant therapy
• Nonvalvular atrial fibrillation
• Healthcare process
• Secondary prevention
• Stroke
• Haemorrhage

Introduction and objectives: To determine, in the various medical specialties, the healthcare process for anticoagulated patients with nonvalvular atrial fibrillation, to determine the available and necessary resources and to identify potential areas of improvement in the care of these patients.
Methods: We performed a cross-sectional survey of primary care and specialised physicians involved in the care of anticoagulated patients. The questionnaires referred to the healthcare process, the indication and prescription of anticoagulant therapy and the barriers and deficiencies present for these patients.
Results: A total of 893 physicians participated in the study, 437 of whom worked in primary care and 456 of whom were specialists (mostly cardiologists). Forty-two percent of the family doctors indicated that they assessed and prescribed anticoagulant therapy, and 66% performed the regular follow-up of these patients. In both healthcare settings, the physicians noted the lack of standardised protocols. There was also a lack of quality control in the treatment.
Conclusions: The role of primary care in managing anticoagulated patients has grown compared with previous reports. The responses of the participating physicians suggest marked gaps in the standardisation of the healthcare process and several areas for improvement in these patients' follow-up. The promotion of training indirect-acting anticoagulant drugs remains pivotal.

• 出版日期2017-5