Atrial fibrillation and thromboprophylaxis in heart failure: the need for patient-centered approaches to address adherence.
Atrial fibrillation is a common arrhythmia in heart failure and a risk factor for stroke. Risk assessment tools can assist clinicians with decision making in the allocation of thromboprophylaxis. This review provides an overview of current validated risk assessment tools for atrial fibrillation and emphasizes the importance of tailoring individual risk and the importance of weighing the benefits of treatment. Further, this review provides details of innovative and patient-centered methods for ensuring optimal adherence to prescribed therapy. Prior to initiating oral anticoagulant therapy, a comprehensive risk assessment should include evaluation of associated cardiogeriatric conditions, potential for adherence to prescribed therapy, frailty, and functional and cognitive ability.
Center for Cardiovascular and Chronic Care, University of Technology, Sydney, Australia. caleb.ferguson@uts.edu.au
Caleb
C
Ferguson
Sally C
SC
Inglis
Phillip J
PJ
Newton
Sandy
S
Middleton
Peter S
PS
Macdonald
Patricia M
PM
Davidson
D000925:Anticoagulants / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D055118:Medication Adherence; D018802:Patient-Centered Care; D018570:Risk Assessment; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D005343:Fibrinolytic Agents
anticoagulation; atrial fibrillation; heart failure; medication adherence; risk stratification; stroke risk