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

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-a...

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Main Authors: Gebreyohannes, Eyob Alemayehu, Salter, Sandra, Chalmers, Leanne, Bereznicki, Luke, Lee, Kenneth
Format: Journal Article
Published: Springer 2020
Online Access:http://hdl.handle.net/20.500.11937/82247
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author Gebreyohannes, Eyob Alemayehu
Salter, Sandra
Chalmers, Leanne
Bereznicki, Luke
Lee, Kenneth
author_facet Gebreyohannes, Eyob Alemayehu
Salter, Sandra
Chalmers, Leanne
Bereznicki, Luke
Lee, Kenneth
author_sort Gebreyohannes, Eyob Alemayehu
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-822472022-01-05T02:09:53Z Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence Gebreyohannes, Eyob Alemayehu Salter, Sandra Chalmers, Leanne Bereznicki, Luke Lee, Kenneth 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. 2020 Journal Article http://hdl.handle.net/20.500.11937/82247 10.1007/s40256-020-00457-3 Springer fulltext
spellingShingle Gebreyohannes, Eyob Alemayehu
Salter, Sandra
Chalmers, Leanne
Bereznicki, Luke
Lee, Kenneth
Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title_full Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title_fullStr Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title_full_unstemmed Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title_short Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
title_sort non-adherence to thromboprophylaxis guidelines in atrial fibrillation: a narrative review of the extent of and factors in guideline non-adherence
url http://hdl.handle.net/20.500.11937/82247