Management of atrial fibrillation:: discrepancy between guideline recommendations and actual practice exposes patients to risk for complications
Management of atrial fibrillation:: discrepancy between guideline recommendations and actual practice exposes patients to risk for complications
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DOI：
10.1053/euhj.2000.2300
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发表时间：
2001-10-01
影响因子：
39.3
通讯作者：
Rosenqvist, M
中科院分区：
文献类型：
--
作者：
Frykman, V;Beerman, B;Rosenqvist, M
Aims To assess compliance to guidelines in management of patients with atrial fibrillation.Methods and Results A total of 728 questionnaire were mailed to physicians with intention of studying“theoretical”compliance to practice guidelines.回顾性评价了200例连续住院房颤患者的记录，以验证“实际”遵守指南。对问卷的回答率为68%，超过94%的医生表示，有血栓栓塞并发症和慢性房颤风险因素的患者应接受长期华法林治疗。评估过的记录。108例患者患有慢性房颤，至少有一种卒中风险因素。并且没有已知的华法林禁忌症。在这一组中，只有40%的人接受华法林治疗。而且。其他几个差异被检测到关于使用抗心律失常治疗。结论这项研究揭示了一个明确的指导方针和房颤患者的实际做法之间的差异。最重要的发现是，在此类事件的高风险患者中，血栓栓塞预防的使用显著不足。房颤管理指南的实施和遵守研究需要通过实际临床实践的调查进行仔细审查，以确定合理的治疗质量。(C)2001年欧洲心脏病学会。
Aims To assess compliance to guidelines in the management of patients with atrial fibrillation.Methods and Results A total of 728 questionnaires were mailed to physicians with the intention of studying 'theoretical' compliance to practice guidelines. A retrospective evaluation of 200 records from consecutive patients hospitalized with atrial fibrillation was performed in order to verify 'actual' compliance to guidelines. The response rate to the questionnaires was 68%, More than 94% of the physicians stated that patients with risk factors for thromboembolic complications and chronic atrial fibrillation should receive long-term warfarin treatment. Of evaluated records. 108 patients were in chronic atrial fibrillation with at least one risk factor for stroke. and with no known contraindication to warfarin. In this group, only 40% received warfarin. Moreover. several other discrepancies were detected as regards the use of antiarrhythmic therapy.Conclusion This study reveals a clear discrepancy between recommendations in guidelines and actual practice in patients with atrial fibrillation. The most important finding was a significant under use of thromboembolic prophylaxis in patients at high risk for such events. Implementation and the study of adherence to management guidelines on atrial fibrillation need to be carefully reviewed by surveys of actual clinical practice in order to establish reasonable therapeutic quality. (C) 2001 The European Society of Cardiology.