title: [Atrial fibrillation and anticoagulation: general practitioner, cardiologist and patient's points of view].
abstract: OBJECTIVE
  This French study was set up to collect perceptions of general practitioners (GPs), cardiologists and patients on anticoagulation therapy with vitamin K antagonists (VKA) in the management of thromboembolic risk in atrial fibrillation (AF).
  
  
  METHODS
  This is a prospective survey conducted in France, between July 1 and August 7 2011, on a sample defined to obtain a sufficient number of patient files of 133 physicians, divided into 65 cardiologists and 68 GPs.
  
  
  RESULTS
  Three hundred and ninety-four patients on VKA and 130 patients not receiving VKA were included in this study. For more than one in three patients, AF was diagnosed incidentally in a medical consultation for another reason. In addition, 15% and 23% of diagnoses of FA were performed after hospitalization for stroke or TIA by cardiologists and GPs, respectively. According to the patient, the doctor contacted first is a GP (52% for the GP vs. 35.5% for the cardiologist), but they state that the diagnosis was made mainly by a cardiologist (63% for the cardiologist vs. 27% for the GP). In 78% of cases, cardiologists are initial prescribers. A CHADS2 score of 0 was found in 23% of patients not receiving VKA and in 11% of patients on VKA. A CHADS2 score superior or equal to 2 is significantly more frequently found in patients with paroxysmal AF. Concerning the monitoring of the patient, GPs ensure mainly monitoring of INR. In terms of compliance, according to doctors, their patients systematically take their treatment in 91% of cases. However, by interviewing patients, 60% of non-compliant patients are considered compliant by their physician.
  
  
  CONCLUSIONS
  This study has achieved an overview of anticoagulation treatment in AF, in France. The initiation is mainly ensured by the cardiologist and the monitoring by the GP. Assessments between cardiologists and GPs are relatively similar, however, it appears that anticoagulation treatment is under-prescribed for the patients at risk.
authors: Médecine générale, 37800 Saint-Épain, France. docliard@orange.fr
authors: François
authors: F
authors: Liard
authors: Jean-Yves
authors: JY
authors: Le Heuzey
authors: Etienne
authors: E
authors: Aliot
authors: Philippe
authors: P
authors: Mabo
authors: Antoine
authors: A
authors: Leenhardt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D001777:Blood Coagulation; D005260:Female; D005602:France; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D010820:Physicians; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000188:drug therapy / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K