An auditfeedback intervention for improved anticoagulant use in patients with atrial fibrillation in primary care
| Autor: | Karin Schenck-Gustafsson, M. von Euler, Lukas Geary, Jan Hasselström, Axel C. Carlsson |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Administration Oral Audit Primary care 030204 cardiovascular system & hematology Feedback 03 medical and health sciences 0302 clinical medicine Intervention (counseling) Atrial Fibrillation medicine Humans Anticoagulant use In patient 030212 general & internal medicine Stroke Primary Health Care business.industry Anticoagulants Atrial fibrillation Odds ratio medicine.disease Emergency medicine Warfarin Cardiology and Cardiovascular Medicine business |
| Zdroj: | International journal of cardiology. 310 |
| ISSN: | 1874-1754 |
| Popis: | Background Improving use of anticoagulants in atrial fibrillation (AF) patients in primary care has proved challenging. Anticoagulants are often prescribed by primary care physicians in the long term. Suboptimal anticoagulant use may be partly due to physicians' non-prescribing. One potential way of targeting physician prescribing behavior is “audit & feedback”. The documented use of audit and feedback in research aimed at increasing use of anticoagulants in primary care is limited. The objective was to test if an audit & feedback intervention aimed at directors in primary care centers could increase the use of anticoagulants in patients with AF. Methods Database generated quality reports with primary care center specific data on recommended medication use in their patients with previous stroke or atrial fibrillation were sent to intervention centers. Results 94 centers received the intervention, 102 centers were controls. 31,477 patients in total were included. Use of anticoagulants in all primary care centers increased from 76% before to 82% after the intervention. Patients in intervention centers were more likely than patients in control centers to use anticoagulants after the intervention, adjusted odds ratio increasing slightly from 1.04 (95%, CI, 0.98–1.10) before to 1.08 (95% CI, 1.02–1.15) after the intervention. Conclusions An audit & feedback intervention with quality reports in primary care had only a small effect on anticoagulant use in patients with AF. A combined and more complex intervention may have a greater effect in improving anticoagulation use. |
| Databáze: | OpenAIRE |
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