dc.contributor.author	Murphy, Aileen	en
dc.contributor.author	Kirby, Ann	en
dc.contributor.author	Bradley, Colin	en
dc.date.accessioned	2024-07-25T08:44:55Z
dc.date.available	2024-07-25T08:44:55Z
dc.date.issued	2020-01-03	en
dc.description.abstract	Background: Direct oral anticoagulants (DOACs) are widely marketed as medicines that do not require routine laboratory monitoring. However, they do have complex pharmacological properties and side effects; hence prescribing and monitoring guidelines, such as the European Heart Rhythm Association (EHRA) guidelines, have emerged. These advocate monitoring for renal and hepatic impairment; bleeding episodes; liver function; co-medication; circulation, and occurrence of side effects. Though 3 to 6 month follow-up is advocated, this is currently not routine, and its implementation creates a potential obligation for general practitioners (GPs) managing atrial fibrillation (AF) patients in the community. Aims: This study investigates the frequency, the type of follow-up, and the factors that influenced follow-up among Irish GPs, who prescribed DOACs to patients with AF, to prevent strokes in 2015. Methods: The frequency and type of follow-up care is estimated, and a count model regression analysis is applied to determine the GP and practice characteristics that are associated with the implementation of follow-up. Results: The EHRA guidelines most frequently followed were those pertaining to renal function (82%), bleeding episodes (71%), liver function (69%), circulation (54%), and side effects (55%). The regression analysis revealed that female GPs (P = 0.05) and GPs who follow all seven guidelines (P = 0.06) practice more frequent follow-up while those in training practices (P = 0.09) provide less frequent follow-up. Conclusions: Results show that there was incomplete adherence to the 2013 EHRA prescribing guidelines with only 24% adhering to all seven guidelines, and patient follow-up was less frequent than has been suggested.	en
dc.description.status	Peer reviewed	en
dc.description.version	Accepted Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.citation	Murphy, A., Kirby, A. and Bradley, C. (2020) ‘Monitoring of atrial fibrillation in primary care patients prescribed direct oral anticoagulants for stroke prevention’, Irish Journal of Medical Science (1971 -), 189(3), pp. 961–966. Available at: https://doi.org/10.1007/s11845-019-02150-0	en
dc.identifier.doi	https://doi.org/10.1007/s11845-019-02150-0	en
dc.identifier.endpage	966	en
dc.identifier.issn	0021-1265	en
dc.identifier.issn	1863-4362	en
dc.identifier.issued	3	en
dc.identifier.journaltitle	Irish Journal of Medical Science	en
dc.identifier.startpage	961	en
dc.identifier.uri	https://hdl.handle.net/10468/16150
dc.identifier.volume	189	en
dc.language.iso	en	en
dc.publisher	Springer	en
dc.relation.ispartof	Irish Journal of Medical Science	en
dc.rights	© Royal Academy of Medicine in Ireland 2019. This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s11845-019-02150-0	en
dc.subject	Adherence	en
dc.subject	Anticoagulation	en
dc.subject	Follow-up care	en
dc.subject	GP prescribing	en
dc.title	Monitoring of atrial fibrillation in primary care patients prescribed direct oral anticoagulants for stroke prevention	en
dc.type	Article (peer-reviewed)	en
oaire.citation.issue	3	en
oaire.citation.volume	189	en

Monitoring of atrial fibrillation in primary care patients prescribed direct oral anticoagulants for stroke prevention

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