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

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

American journal of cardiovascular drugs : drugs, devices, and other interventions 2021 Jul

filter terms:

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.

Citation

Eyob Alemayehu Gebreyohannes, Sandra Salter, Leanne Chalmers, Luke Bereznicki, Kenneth Lee. Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence. American journal of cardiovascular drugs : drugs, devices, and other interventions. 2021 Jul;21(4):419-433