Non-adherence to thromboprophylaxis guidelines in atrial fibrillation: a narrative review of the extent of and factors in guideline non-adherence
Date
2021
Authors
Gebreyohannes, E.A.
Salter, S.
Chalmers, L.
Bereznicki, L.
Lee, K.
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Journal article
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American Journal of Cardiovascular Drugs, 2021; 21(4):419-433
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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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Link to a related website: https://unpaywall.org/10.1007/s40256-020-00457-3, Open Access via Unpaywall
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Copyright 2020 Springer Nature Switzerland AG