Are your patients aware of their risk?
Did you know that:
- Over 1 million people in the UK have atrial fibrillation (AF).
- The risk of stroke is five times greater for people with AF.
- AF contributes to 1 in 5 strokes in the UK.
- The incidence of AF increases with age.
- AF-related strokes are often more severe, with higher mortality and greater disability.
- AF often goes undiagnosed.
It is estimated there could be another half a million people in the UK with undiagnosed AF.
To help your patients understand more about AF, we have a number of resources available, which include AF: reducing your risk of stroke and an atrial fibrillation factsheet. See below for more useful resources.
Treatment and managing atrial fibrillation (AF)
Aspirin monotherapy is no longer recommended by NICE as a treatment for AF. All patients with AF should be appropriately anticoagulated to reduce the risk of AF-related stroke. However, anticoagulants continue to be under-prescribed. In the UK, around a quarter of eligible patients with AF do not receive anticoagulation.
Why is it important to review the needs of your patients with AF?
It's estimated that if AF was adequately treated, around 7,000 strokes would be prevented and over 2,000 lives saved every year in England alone.
However, currently less than half of UK patients with known AF are on anticoagulant medication when they go to the hospital with a stroke. Anticoagulation may be with either apixaban, dabigatran, edoxaban, rivaroxaban or a vitamin K antagonist such as warfarin, as recommended by NICE.
It's important to consider all available treatment options, and a decision should be made between the patient and doctor based on individual needs and preferences.
Figures taken from the Stroke Association: State of the Nation 2017.
Treating AF to reduce the risk of stroke - a professional perspective
AF Detection and Diagnosis Pathway
Read about the Atrial Fibrillation detection and diagnosis pathway.
This resource has been co-developed by Trudie Lobban MBE, Dr Jim Moore, Professor Simon Ray, Helen Williams and the Stroke in Atrial Fibrillation Initiative (SAFI) which comprises the pharmaceutical companies Bayer, Daiichi Sankyo UK, Bristol Myers Squibb Pharmaceuticals Limited and Pfizer operating as the BMS-Pfizer Alliance. No funding has been provided by the SAFI group to individuals or organisations involved in the pathway co-development. SAFI has provided funding to Policy Matters as the SAFI secretariat to provide meeting logistics, practical assistance with materials development and support to coordinate pathway development. As SAFI will be disbanding, ownership of and responsibility for the pathway and associated materials will transfer to the Primary Care Cardiovascular Society following the launch on 2 March 2023.
AF: How can we do better?
You can find out the state of AF care in England, and in each individual CCG, through our 'AF: How can we do better?' resources.
These are available in an England summary, and via the links below.
These resources have been developed in partnership with Public Health England, Royal College of Physicians, Royal College of General Practitioners and British Heart Foundation.
The data included is compiled from the Quality and Outcomes Framework (QOF), Public Health England (PHE), Sentinel Stroke National Audit Programme (SSNAP) and NHSIQ.
Patient case studies
David Derrett talks about his experience of AF and stroke:
Watch more videos on managing atrial fibrillation on the British Heart Foundation's YouTube channel.
AF resources for you and your patients
Hard copies of our factsheets and leaflets for patients are available to order from our online shop.
- AF: what you need to know: A professionals-facing leaflet includes an ideal AF patient pathway and useful advice for identifying, treating and managing AF.
- AF: reducing your risk of stroke: A patient-facing leaflet covering the link between atrial fibrillation and stroke, possible symptoms, treatment and other things you can do to reduce your risk of stroke.
- Atrial fibrillation factsheet: Offering detailed information on AF symptoms, different types of treatment and where you can find out more.
To help support practitioners in their discussion with patients on anticoagulation, the Wessex AHSN, in partnership with Royal Pharmaceutical Society and Hampshire Hospitals NHS Foundation Trust have developed an anticoagulation video and leaflet.
For statistics and key information about the prevalence of AF in the UK and the link between AF and stroke, take a look at our State of the Nation 2017 report.
Public Health England and the AHSNs have collaborated to create an AF Care Pathway Business Case Model. The model assesses each management opportunity in AF to identify any potential deficits in current care, the cost impact on the local health economy, and the number of strokes that could be prevented and lives saved as a result of improvements in anticoagulation treatment patterns.
Your organisation could use this model to review a set of specific interventions to address local needs and evaluate the most efficient focus of investment and resources in your region.
AF Toolkit: Detect, Protect and Perfect
There is evidence of outstanding work delivered by the NHS, charities and industry to improve AF care and outcomes for patients within London and nationally.
Use this useful AF toolkit from the AHSN Network, which provides methodologies, resources and support for commissioners and clinicians working to reduce AF-related strokes.
Best practice case studies
Our best practice professional case studies detail some examples of the great work CCGs across the UK are doing to improve AF detection and management:
- Anticoagulant Programme - East London
- Anticoagulation decision support tool - Keele
- AF dashboard - West Midlands
- Bradford Healthy Hearts - Bradford
- Improving AF diagnosis and management - East Midlands
- Know Your Pulse events - Lancashire
- Buckinghamshire's 'Excellence in AF partnerships' project
If you would like to share details of some of the work in your area, please get in touch.