Multifaceted Intervention Improves Anticoagulant Use in Patients With Atrial Fibrillation
Intervention Might Help Patients Worldwide
The majority of participants were using vitamin K antagonists at baseline, and data suggest that non-vitamin K antagonists have advantages (eg, reduced intracerebral bleeds) over this class of oral anticoagulants. Approximately 8% of participants in the intervention group had switched from vitamin K antagonists to non-vitamin K antagonists at one year, while participants in the control group did not change their medication. “A similar educational approach could be used for all anticoagulant classes with even greater benefit to patients,” said Michael D. Ezekowitz, MD, a cardiologist at Lankenau Medical Center in Wynnewood, Pennsylvania, and Anthony P. Kent, MD, a resident at Bridgeport Hospital in Bridgeport, Connecticut, in an accompanying editorial.
The study was limited to five countries and relied on a technological intervention, which might hinder the generalization of the results to broader clinical practice, said Drs. Ezekowitz and Kent. Nevertheless, “we are confident that the impact of IMPACT-AF will benefit patients with atrial fibrillation worldwide,” they concluded.
—Erik Greb
Suggested Reading
Ezekowitz MD, Kent AP. The impact of IMPACT-AF. Lancet. 2017 Aug 28 [Epub ahead of print].
Vinereanu D, Lopes RD, Bahit MC, et al. A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial. Lancet. 2017 Aug 28 [Epub ahead of print].
