Atrial Fibrillation Clinical Trial
Official title:
Impact of a Quality Improvement And Education Initiative on 'Appropriate' Use of Anticoagulant Therapy in Patients With Atrial Fibrillation
Study objective was to improve decision-making and thromboprophylaxis for patients with Atrial Fibrillation (AF) by developing and implementing a computerized decision support tool for individual patient-level decision-making about oral anticoagulant therapy. To accomplish these goals, the investigators studied the incremental impact of adding a quality-improvement (QI) intervention to an educational package (for practice staff and clinicians) using a computerized aid, the Atrial Fibrillation Decision Support Tool (AFDST) for individual patient-level decision-making about oral anticoagulant therapy in patients with non-valvular AF. The decision support tool incorporates individual patients' risk factor profiles for ischemic stroke and bleeding and provides a recommendation for treatment based upon the projected quality-adjusted life expectancy gained or lost with the addition of either oral anticoagulant therapy or aspirin compared with no thromboprophylaxis.
Setting - Cluster randomized trial. Setting - Primary care practices of an integrated
healthcare system. Participants - 1,493 adults with non-valvular AF seen between April 2014
and March 2015.
Intervention - Treatment recommendations were made by an Atrial Fibrillation Decision Support
Tool (AFDST) based on projections for quality-adjusted life expectancy calculated by a
decision analytic model that integrates patient-specific risk factors for stroke and
hemorrhage.
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