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Addressing Disparities in Stroke Prevention for Atrial Fibrillation: Educational Opportunities
This study identified barriers to optimal stroke prevention to develop a framework for clinician education. A comprehensive educational needs assessment was developed focusing on clinicians within the Stroke Belt. The mixed qualitative-quantitative approach included regional surveys and one-on-one clinician interviews. Identified contributors to disparities included implicit racial biases, lack of awareness of racial disparities in AF stroke risk, and lack of effective multicultural awareness and training. Additional barriers affecting disparities included patient medical mistrust and clinician-patient communication challe...
Source: American Journal of Medical Quality - June 30, 2016 Category: Health Management Authors: Karcher, R., Berman, A. E., Gross, H., Hess, D. C., Jauch, E. C., Viser, P. E., Solenski, N. J., Wolf, A. M. D. Tags: Articles Source Type: research

The Educational Needs of Clinicians Regarding Anticoagulation Therapy for Prevention of Thromboembolism and Stroke in Patients With Atrial Fibrillation
The objective is to identify practice patterns and attitudes of and barriers faced by US physicians assessing thromboembolism/stroke risk and managing anticoagulation in atrial fibrillation (AF) to determine educational needs. Case-based surveys were used to assess practice patterns, guideline use, barriers, and attitudes; 51 cardiologists and 50 primary care physicians (PCPs) were surveyed. Most cardiologists use validated risk scoring systems to assess thromboembolism/stroke risk, and more than half of PCPs use clinical experience. Assessment of bleeding risk varied; more than half of respondents rely on clinical judgmen...
Source: American Journal of Medical Quality - January 4, 2016 Category: Health Management Authors: Glauser, T. A., Barnes, J., Nevins, H., Cerenzia, W. Tags: Articles Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research

Aspirin risks in perspective: A comparison against marathon running
Aspirin has public health potential to reduce the risk of ischaemic vascular events and sporadic cancer. One objection to the wider use of aspirin for primary prevention, however, is the undesirable effects of the medicine, which include increasing risk of bleeding and haemorrhagic stroke. Marathons also carry risks of serious events such as cardiac arrests and sudden death. Based on epidemiological estimates, a person running a marathon might be 20 to 100 times more likely to end up in hospital than a person who is taking an aspirin tablet. Yet the cumulative risk of daily aspirin use for primary prophylaxis may be import...
Source: Health Education Journal - June 10, 2014 Category: Health Management Authors: Morgan, G. Tags: Short Report Source Type: research