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Around 2.5 per cent of the population has atrial fibrillation (AF) although not all these patients are currently diagnosed
There is a five-fold increase risk of stroke in patients with AF. Appropriate use of anticoagulation is key to reducing the mortality and morbidity of AF-related strokes
An assessment of stroke/bleeding risk should be undertaken and where appropriate anticoagulation should be offered to reduce stroke risk
Increasingly, direct oral anticoagulants (DOACs) are offered as the first choice anticoagulant for patients with non-valvular AF. The dosage should reflect the licensed dose and take into account the patient’s renal function
Warfarin should continue to be prescribed if the patient has a mechanical heart valve, moderate to severe mitral stenosis, or prefers to use the drug
Where warfarin is prescribed for AF, the target INR is usually 2.5 +/-0.5. The time in therapeutic range should be evaluated, aiming for a value of at least 65 per cent
Supporting patient education and adherence to anticoagulation is a key role for community pharmacy teams
Key facts
