OBJECTIVE: @entity64 -risk in @entity955 ( @entity955 ) can be significantly reduced by appropriate @entity1031 prophylaxis. However, National Institute for Health and Care Excellence estimates suggest that up to half of eligible @entity1 with @entity955 are not anticoagulated, with severe consequences for @entity64 prevention. We aimed to determine the outcome of an innovative Primary Care @entity955 (PCAF) service on anticoagulation uptake in a cohort of high-risk @entity1 with @entity955 in the UK. METHODS: The PCAF service is a novel cooperative pathway providing specialist resources within general practitioner (GP) practices. It utilises a four-phase protocol to identify high-risk @entity1 with @entity955 (CHA2DS2-VASc >= 1) who are suboptimally anticoagulated, and delivers Consultant-led anticoagulation assessment within the local GP practice. We assessed rates of anticoagulation in high-risk @entity1 before and after PCAF service intervention, and determined compliance with newly-initiated anticoagulation at follow-up. RESULTS: The PCAF service was delivered in 56 GP practices (population 386   624; @entity955 prevalence 2.1%) between June 2012 and June 2014. 1579 high-risk @entity1 with @entity955 with suboptimal anticoagulation (either not taking any anticoagulation or taking @entity1229 but with a low time-in-therapeutic-range) were invited for review, with 86% attending. Of 1063 eligible @entity1 on no anticoagulation, 1020 (96%) agreed to start @entity1229 (459 (43%)) or a non- @entity2067 antagonist oral anticoagulant (NOAC, 561 (53%)). The overall proportion of eligible patients receiving anticoagulation improved from 77% to 95% (p<0.0001). Additionally, 111/121 (92%) @entity1 suboptimally treated with @entity1229 agreed to switch to a NOAC. Audit of eight practices after 195 (185-606) days showed that 90% of @entity1 started on a new anticoagulant therapy had continued treatment. Based on data extrapolated from previous studies, around 30-35 @entity64 per year may have been prevented in these previously under-treated high-risk @entity1 . CONCLUSIONS: Systematic identification of @entity1 with @entity955 with high @entity64 -risk and consultation in PCAF consultant-led clinics effectively delivers oral anticoagulation to high-risk @entity1 with @entity955 in the community.

Primary Care XXXX Service: outcomes from consultant-led anticoagulation assessment clinics in the primary care setting in the UK.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['strokes', 'stroke', 'Stroke'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation', 'AF'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin']
@entity955 :: (MESH:D001281,Disease) :: ['Atrial Fibrillation']
