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RE:LY Dabigatran AF study concludes...
"In patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage. Dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage."
New Edition
The 3rd edition of “Oral Anticoagulation Management and Stroke Prevention” is now available. The primary care perspective provides a valuable reference source, together with a useful the
Anticoagulation in Practice 2010
The Fourth Joint Scientific Meeting of The Anticoagulation Working Party of the PCCS, Anticoagulation Specialist Association, Anticoagulation Europe and Clinical Leaders of Thrombosis.
General Practitioners, Practice Nurses, Biomedical Scientists, Pharmacists and Patients are all invited to attend Anticoagulation in Practice 2010 at the Wolfson Centre, a state of the art conference facility within the Medical School of University of Birmingham. Event details...
National Pharmacy Association SOP for supplying
anticoagulant therapy
The NPA has produced a new standard operating procedure (SOP) for the supply of anticoagulant therapy. The document provides details of the National Patient Safety Agency (NPSA) patient alert “NPSA Alert 18 - Actions that can make Anticoagulant Therapy Safer”.
The SOP is freely available for download from the NPA website
Good news for hip and knee surgery patients
On March 18, 2008, the European Medicines Agency granted marketing authorisation for dabigatran. The National Health Service have authorised the use of Pradaxa (developed by pharmaceutical company Boehringer-Ingelheim) for use in preventing venous embolism in patients who have undergone orthopaedic surgery.
“External quality assessment (EQA) should be an inherent component of patient self-management (PSM) of oral anticoagulation.”
A recent study: Quality assurance for oral anticoagulation self management QAASM: a cluster randomised trial, has yielded results indicating patients are able to undertake a formal EQA scheme and perform more reliably at home independently. The paper is an online accepted article of the British Journal of Thrombosis and Haematosis, click here to read more...
"Patient self-monitoring is as effective as good quality specialised anticoagulation clinics in maintaining the quality of anticoagulation therapy." Health Technology Assessment 2007; Vol 11: number 38
The National Institute for Health Research Health Technology Assessment Programme (HTA) produces independent research about the effectiveness of different healthcare treatments and tests for those who use, manage and provide care in the NHS. A systematic review and economic modelling of the clinical effectiveness and cost-effectiveness
of different models of managing long-term oral anticoagulation therapy was recently published, it concludes 'For selected and successfully trained patients, self-monitoring is effective and safe for long term oral anticoagulation therapy.'
Read / download full text (PDF)
Research Updates
BAFTA
Birmingham Atrial Fibrillation Treatment in the Aged Study
This landmark study has demonstrated that warfarin is twice as effective as aspirin in protecting against stroke in patients with atrial fibrillation aged 75 and over, whilst being equally as safe in terms of haemorrhagic side-effects.
Mant J, Hobbs FDR, Fletcher K, Roalfe A, Fitzmaurice DA, Lip GYH, Murray ET.
Warfarin versus aspirin for stroke prevention in an elderly population with atrial fibrillation (the Birmingham Atrial Fibrillation treatment of the Aged Study, BAFTA): a randomized controlled trial.
Lancet 2007;370:493-503
SAFE
Screening for Atrial Fibrillation in the Elderly
This Department of Health funded study has demonstrated unequivocally that screening for atrial fibrillation significantly increases the detection of this important condition, and perhaps surprisingly, that opportunistic screening, using pulse palpation followed by ECG, is the most cost-effective screening option
Fitzmaurice DA, Hobbs FDR, Jowett J, Mant J, Murray ET, Holder R, Raftery JP, Bryan S, Davies M, Lip GYH, Allan TF.
Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial.
BMJ 2007;335:383, doi:10.1136/bmj.39280.660567.55 (published 2 August 2007)
SAFE Companion paper
This SAFE companion paper has demonstrated that, whilst computerised diagnostic software performs better than primary care health professionals in diagnosing atrial fibrillation, in order to ensure a definitive diagnosis a consultant cardiologist needs to report on a 12 lead ECG.
Mant J, Fitzmaurice DA, Hobbs FDR, Jowett S, Murray ET, Holder R, Davies M, Lip GHY.
Accuracy of diagnosing atrial fibrillation on electrocardiogram by primary care practitioners and interpretative diagnostic software: analysis of data from screening for atrial fibrillation in the elderly (SAFE) trial.
BMJ 2007;335: 380, doi:10.1136/bmj.39227.551713.AE (published 29 June 2007)
More information on cardiovascular research at the University of Birmingham.
Details of other research conducted by the University of Birmingham's Department of Primary Care and General Practice can be found here.
NOTE: This site is a source of information, links & references. It is NOT a helpline. Patients with questions regarding anticoagulant treatment, please contact your doctor.
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