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American Journal of Cardiovascular Drugs
Published in: American Journal of Cardiovascular Drugs 4/2021

01-07-2021 | Stroke | Review Article

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

Authors: Eyob Alemayehu Gebreyohannes, Sandra Salter, Leanne Chalmers, Luke Bereznicki, Kenneth Lee

Published in: American Journal of Cardiovascular Drugs | Issue 4/2021

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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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Metadata
Title
Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
Authors
Eyob Alemayehu Gebreyohannes
Sandra Salter
Leanne Chalmers
Luke Bereznicki
Kenneth Lee
Publication date
01-07-2021
Publisher
Springer International Publishing
Published in
American Journal of Cardiovascular Drugs / Issue 4/2021
Print ISSN: 1175-3277
Electronic ISSN: 1179-187X
DOI
https://doi.org/10.1007/s40256-020-00457-3

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