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Use of direct oral anticoagulants for stroke prevention in elderly patients with nonvalvular atrial fibrillation
ConclusionsDOACs are at least as effective as warfarin for stroke prevention in elderly patients with NVAF. Compared with warfarin, DOACs were associated with reduced risk of intracranial hemorrhage, while some DOACs demonstrated an increase in other bleeding events (e.g., gastrointestinal). The faster onset and offset of action and fewer food and drug interactions of DOACs may be an advantage over warfarin for some patients. Implications for practiceDOACs are an alternative to warfarin with overall equivalent safety and efficacy in elderly patients with NVAF, and may be preferable for some. Stroke risk must always be bala...
Source: Journal of the American Academy of Nurse Practitioners - August 14, 2017 Category: Nursing Authors: Lynn B. Oertel, Annemarie E. Fogerty Tags: REVIEW ‐ SPONSORED Source Type: research

Transitions of care for stroke and TIA
ConclusionHospital length of stay, age, insurance status, discharge disposition, comorbidities, and readmission rates were identified as important elements affecting TOC for stroke and TIA. Information from patient surveys indicated that emotional health, follow‐up with care providers, stroke education, and point of contact are important elements during the transition periods after stroke and TIA. Implications for practiceBoth providers and patients should inform the development of a comprehensive TOC program that spans in‐hospital to multiple care settings, including the home, which is essential. The advanced practice...
Source: Journal of the American Academy of Nurse Practitioners - March 4, 2015 Category: Nursing Authors: Helena N. Haynes, Matthew J. Gallek, Kate G. Sheppard, Kendra W. Drake, Leslie S. Ritter Tags: QUALITY IMPROVEMENT Source Type: research

Dabigatran etexilate: An alternative to warfarin for patients with nonvalvular atrial fibrillation
ConclusionsSignificant evidence from the PETRO and RE‐LY trials and postmarketing analyses of dabigatran etexilate indicate that this direct thrombin inhibitor is as efficacious as warfarin in ischemic stroke prevention. In fact, the studies found that patients taking dabigatran etexilate had fewer incidences of ischemic stroke and intracranial hemorrhage than those taking warfarin. Risk for major gastrointestinal bleeding appears to be higher than that for warfarin. Implications for practicePatients taking dabigatran etexilate do not require blood work to assess international normalized ratio (INR) levels. Because this ...
Source: Journal of the American Academy of Nurse Practitioners - July 25, 2014 Category: Nursing Authors: Katie A. Scott, Karen A. Amirehsani Tags: CLINICAL PRACTICE Source Type: research