Values and preferences for oral antithrombotic therapy in patients with atrial fibrillation: physician and patient perspectives
Why the study?
What is the threshold risk of bleeding that patients and physicians are willing to tolerate with oral antithrombotic therapy to prevent stroke in atrial fibrillation?
Population
96 outpatients at risk of developing atrial fibrillation and 96 physicians who manage patients with atrial…
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Supports individualized AF antithrombotic counseling; leaves open effects on adherence or outcomes.
Structured PICO
What is the threshold risk of bleeding that patients and physicians are willing to tolerate with oral antithrombotic therapy to prevent stroke in atrial fibrillation?
P
Population
96 outpatients at risk of developing atrial fibrillation and 96 physicians who manage patients with atrial fibrillation (total n=192)
I
Intervention
Interview eliciting the maximal increased risk of bleeding (threshold risk) tolerated with warfarin vs. aspirin to achieve a reduction in 3 strokes per 100 patients over 2 years using the probabilistic version of the threshold technique
O
Outcome
Maximal increased risk of bleeding (threshold risk) toleratedpatient reported
There is wide variability and frequent discordance between patient and physician preferences regarding the trade-off between stroke prevention and bleeding risk in atrial fibrillation, highlighting the need for individualized shared decision-making.
Cite This Study
Alonso‐Coello et al. (2014) studied this question.