Abstract 19900: Lack of Patient Understanding of Stroke Risk and Treatment Strategies in Those With Newly Diagnosed Atrial Fibrillation: A Concern and an Opportunity
Introduction: Patient understanding of stroke risk and available therapies are key components of shared medical decision making and long-term medication adherence. Yet, relatively little is known regarding how well disease and treatment knowledge is reaching atrial fibrillation (AF) patients in routine community practice.
Hypothesis: AF patients’ reported level of understanding of stroke risk and the benefits of oral anticoagulant (OAC) therapy are suboptimal.
Methods: We used data from SATELLITE, a substudy of new-onset AF patients enrolled at 59 US sites participating in the ORBIT-AF registry. Patients were surveyed at the baseline clinic visit using Likert scales.
Results: Of 563 patients enrolled in SATELLITE, median age was 69.0 years (IQR 61.0 - 76.0), 42.5% were women, and 92.2% were white. The majority of patients listed their healthcare provider as their top source of information for AF (71.6%), followed by the internet (12.7%), other AF patients (9.1%) and television (8.2%). Overall, 63.8% of patients reported that they “strongly agreed” that stroke was the major risk associated with AF. Conversely, heart attack was perceived as a major risk of AF (32.6%), as were sudden death (28.9%), bleeding (27.0%), and cancer (7.5%). Less than one-quarter of patients indicated that they completely understood the benefits of warfarin (24.0%) and NOAC therapy (22.6%). Less than one-third of patients indicated that they completely understood the available options for AF (Figure) , and a substantial proportion indicated that they had never heard of warfarin (13.5%) or NOACs (9.8%).
Conclusions: A large minority of patients with new-onset AF in community practice cannot correctly identify the major AF risk factors or available therapeutic options. This lack of knowledge should be considered as a major concern but also an obvious target for improvement.
- Atrial fibrillation
- Patient education/teaching psychosocial aspects
- Disease management
- Quality of medical care
Author Disclosures: E.C. O’Brien: Other Research Support; Modest; NIH, PCORI, Bristol-Myers Squibb, GlaxoSmithKline, Janssen Scientific, and Boehringer-Ingelheim. Consultant/Advisory Board; Modest; Portola Pharmaceuticals. L.A. Allen: Consultant/Advisory Board; Modest; J&J, Novartis, St. Jude. S. Kim: None. P. Shrader: None. B.J. Gersh: Consultant/Advisory Board; Modest; Medtronic Inc, Baxter Healthcare Corporation, Cardiovascular Research Foundation, St. Jude Medical, Ortho-McNeil-Janssen Pharmaceuticals, Teva Pharmaceuticals, Boston Scientific, Pfizer. G.V. Naccarelli: Consultant/Advisory Board; Significant; Janssen, Pfizer, Boehringer-Ingelheim, Daiichi Sankyo, GlaxoSmithKline, Astra Zeneca. G.C. Fonarow: Other; Significant; Serves as Vice Chair of the ACC/AHA Task Force on Performance Measures. J.P. Piccini: Research Grant; Significant; ARCA Biopharma, GE Healthcare, Johnson & Johnson, Resmed. Consultant/Advisory Board; Modest; Forest Laboratories, Johnson & Johnson, Spectranetics, Medtronic. E.D. Peterson: Research Grant; Significant; Janssen Pharmaceutical Products. Consultant/Advisory Board; Modest; Janssen Pharmaceutical Products, Regeneron Pharmaceuticals Inc, Sanofi-Aventis. Consultant/Advisory Board; Significant; AstraZeneca, Bayer Corporation US, Boehringer Ingelheim, Merck & Co, Valeant.
- © 2016 by American Heart Association, Inc.