Adherence to treatment guidelines: the association between stroke risk stratified comparing CHADS₂ and CHA₂DS₂-VASc score levels and warfarin prescription for adult patients with atrial fibrillation

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• 作者：Scott A. Chapman ; Catherine A. St Hill ; Meg M. Little…
• 关键词：Warfarin ; CHADS2 ; CHA2DS2 ; VASc ; Atrial fibrillation ; Stroke ; Guideline Adherence ; Anti ; coagulation ; Interprofessional health care teams
• 刊名：BMC Health Services Research
• 出版年：2017
• 出版时间：December 2017
• 年：2017
• 卷：17
• 期：1
• 全文大小：427KB
• 刊物主题：Public Health; Health Administration; Health Informatics; Nursing Research;
• 出版者：BioMed Central
• ISSN：1472-6963
• 卷排序：17

文摘

BackgroundIschemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS₂, and more recently the CHA₂DS₂-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy. Warfarin, for stroke prevention in AF, is the most commonly prescribed anticoagulant in North America. The purpose of this study was to examine the utility of using the CHADS₂ score levels (low and high) in contrast to the CHA₂DS₂-VASc when examining the outcome of warfarin prescriptions for adult patients with AF. The CHA₂DS₂-VASc tool was not widely used in 2010, when the data analyzed were collected. It has only been since 2014 that CHA₂DS₂-VASc criteria has been recommended to guide anticoagulant treatment in updated AF treatment guidelines.