Impact of an Atrial Fibrillation Decision Support Tool (AFDST) on Thromboprophylaxis for Atrial Fibrillation
This trial is active, not recruiting.
|Conditions||atrial fibrillation, atrial flutter|
|Treatments||decision support, educational intervention only|
|Sponsor||University of Cincinnati|
|Start date||December 2012|
|End date||March 2016|
|Trial size||70 participants|
|Trial identifier||NCT02524977, 2013-0017|
Study objective was to improve decision-making and thromboprophylaxis for AF patients in our system's primary care network by developing and implementing a computerized decision support tool for individual patient-level decision-making about oral anticoagulant therapy. To accomplish these goals, we studied the impact of a combination of education related to anticoagulation therapy and 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 QI 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.
|Intervention model||parallel assignment|
|Primary purpose||health services research|
Changes in Discordant Antithrombotic Therapy
time frame: One year
Male or female participants of any age.
Inclusion Criteria: - Study subjects were physicians in our primary care network. - Patients included in the study were identified through our health system's clinical data store with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), diagnosis of atrial fibrillation (427.31) or atrial flutter (427.32) who did not have diagnoses of mitral valve disease (394.x), aortic valve disease (395.x), heart valve transplant (V42.2) or heart valve replacement (V42.3). Exclusion Criteria: - None
|Official title||Impact of a Quality Improvement And Education Initiative on 'Appropriate' Use of Anticoagulant Therapy in Patients With Atrial Fibrillation|
|Description||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.|
Call for more information