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Screening over 100 000 patients in 39 general practices in the Netherlands for anticoagulation underprescription in atrial fibrillation: a descriptive, cross-sectional study
Conclusions In this large Dutch study among GPs, we observed 9.8% underprescription of OAC in AF patients. In 76% of the AF patients lacking a prescription for OAC, no documentation for deviating from the guidelines was found. Only in a minority of cases detection of OAC underprescription lead to OAC initiation.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Voorhout, L., Pisters, R., Geurts, C. H. P. H., Oostindjer, A., van Doorn, S., Rila, H., Fuijkschot, W. W., Verheugt, F., Hemels, M. E. W. Tags: Open access, Cardiovascular medicine Source Type: research

Progression of stroke risk in patients aged & lt;65 years diagnosed with atrial fibrillation: a cohort study in general practice
CONCLUSION: People aged <65 years with AF are at higher risk of developing hypertension, heart failure, and diabetes than the general population, so may warrant regular review to identify new occurrence of such risk factors.PMID:37487643 | DOI:10.3399/BJGP.2022.0568
Source: The British Journal of General Practice - July 24, 2023 Category: Primary Care Authors: Silvia C Mendon ça Duncan A Edwards Jenny Lund Catherine L Saunders Jonathan Mant Source Type: research

Prescriptive behavior of non-vitamin K oral anticoagulants in patients affected by atrial fibrillation in general practice
Biomed Pharmacother. 2023 Jun 21;165:115020. doi: 10.1016/j.biopha.2023.115020. Online ahead of print.ABSTRACTAtrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and in recent years the pharmacological approach has been strongly implemented; in Italy, the prescription of the non-vitamin K oral anticoagulants (NOAC) was also extended to General Practitioners (GPs) since 2020. The aim of the present study was to investigate the GPs prescribing behaviour of NOACs. An observational study was performed by using the computerized medical record of 14 GPs in Sicily: patients affected by AF were selected and st...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - June 23, 2023 Category: Drugs & Pharmacology Authors: M Rottura S F A Drago A Molonia N Irrera S Marino R Scoglio L Orlando M Gigliotti De Fazio F Squadrito V Arcoraci E Imbalzano on the behalf of Audit & Research Messina Primary Care Group Source Type: research

Social bias in artificial intelligence algorithms designed to improve cardiovascular risk assessment relative to the Framingham Risk Score: a protocol for a systematic review
This study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provid...
Source: BMJ Open - May 31, 2023 Category: General Medicine Authors: Garcha, I., Phillips, S. P. Tags: Open access, General practice / Family practice Source Type: research

Statins for extension of disability-free survival and primary prevention of cardiovascular events among older people: protocol for a randomised controlled trial in primary care (STAREE trial)
Introduction The world is undergoing a demographic transition to an older population. Preventive healthcare has reduced the burden of chronic illness at younger ages but there is limited evidence that these advances can improve health at older ages. Statins are one class of drug with the potential to prevent or delay the onset of several causes of incapacity in older age, particularly major cardiovascular disease (CVD). This paper presents the protocol for the STAtins in Reducing Events in the Elderly (STAREE) trial, a randomised double-blind placebo-controlled trial examining the effects of statins in community dwelling o...
Source: BMJ Open - April 3, 2023 Category: General Medicine Authors: Zoungas, S., Curtis, A., Spark, S., Wolfe, R., McNeil, J. J., Beilin, L., Chong, T. T.-J., Cloud, G., Hopper, I., Kost, A., Nelson, M., Nicholls, S. J., Reid, C. M., Ryan, J., Tonkin, A., Ward, S. A., Wierzbicki, A., On behalf of STAREE investigator group Tags: Open access, Cardiovascular medicine Source Type: research

Cardiovascular-related conditions and risk factors in primary care for deprived communities before and during the COVID-19 pandemic: an observational study in Northern England
Conclusion Recorded CVD-related risk factors and conditions remained comparable before and during COVID-19. These are higher in the Deep End than in England and similar or lower than the non-Deep End, with a higher optimal statin prescribing rate. However, it was not possible to control for age and sex. More work is needed to estimate the consequences of the pandemic on disadvantaged communities and to compare whether the findings are replicated in other areas of deprivation.
Source: BMJ Open - November 22, 2022 Category: General Medicine Authors: Fu, Y., Price, C., Haining, S., Gaffney, B., Julien, D., Whitty, P., Newton, J. L. Tags: Open access, Public health, COVID-19 Source Type: research

Using primary care data to assess comparative effectiveness and safety of apixaban and rivaroxaban in patients with nonvalvular atrial fibrillation in the UK: an observational cohort study
Conclusions Among patients with nonvalvular AFib, apixaban was as effective as rivaroxaban in reducing rate of stroke and safer in terms of major bleeding episodes. This head-to-head comparison supports conclusions drawn from indirect comparisons of DOAC trials against warfarin and demonstrates the potential for real-world evidence to fill evidence gaps and reduce uncertainty in both health technology assessment decision-making and clinical guideline development.
Source: BMJ Open - October 17, 2022 Category: General Medicine Authors: Jaksa, A., Gibbs, L., Kent, S., Rowark, S., Duffield, S., Sharma, M., Kincaid, L., Ali, A. K., Patrick, A. R., Govil, P., Jonsson, P., Gatto, N. Tags: Open access, Cardiovascular medicine Source Type: research

Cluster randomised controlled trial of screening for atrial fibrillation in people aged 70 years and over to reduce stroke: protocol for the pilot study for the SAFER trial
Introduction Atrial fibrillation (AF) is a common arrhythmia associated with 30% of strokes, as well as other cardiovascular disease, dementia and death. AF meets many criteria for screening, but there is limited evidence that AF screening reduces stroke. Consequently, no countries recommend national screening programmes for AF. The Screening for Atrial Fibrillation with ECG to Reduce stroke (SAFER) trial aims to determine whether screening for AF is effective at reducing risk of stroke. The aim of the pilot study is to assess feasibility of the main trial and inform implementation of screening and trial procedures. Metho...
Source: BMJ Open - September 9, 2022 Category: General Medicine Authors: Williams, K., Modi, R. N., Dymond, A., Hoare, S., Powell, A., Burt, J., Edwards, D., Lund, J., Johnson, R., Lobban, T., Lown, M., Sweeting, M. J., Thom, H., Kaptoge, S., Fusco, F., Morris, S., Lip, G., Armstrong, N., Cowie, M. R., Fitzmaurice, D. A., Free Tags: Open access, Public health Source Type: research

How is atrial fibrillation detected in everyday healthcare? Results of a  Dutch cohort study
CONCLUSION: Diagnosing AF is a multidisciplinary process. The irregular heartbeat was most often detected by the GP, but cardiologists diagnosed most cases. One-third of all newly diagnosed AF was silent.PMID:36048351 | DOI:10.1007/s12471-022-01719-2
Source: Netherlands Heart Journal - September 1, 2022 Category: Cardiology Authors: N Verbiest-van Gurp S B Uittenbogaart S C M van de Moosdijk U F van Sprang J A Knottnerus H E J H Stoffers W A M Lucassen Source Type: research

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