title: The caregiver role in thromboprophylaxis management in atrial fibrillation: a literature review.
abstract: BACKGROUND
  Atrial fibrillation is a common arrhythmia and a risk factor for adverse events including stroke. People living with atrial fibrillation are commonly elderly and have multiple comorbidities. The role of a caregiver in supporting the individual to manage a chronic and complex condition has received limited attention.
  
  
  OBJECTIVE
  This review aims to summarize available information on the caregiver role in atrial fibrillation, specifically in promoting adherence to thromboprophylaxis and evidence for strategies to support and enable the caregiver.
  
  
  METHODS
  A review of electronic databases and search engines was undertaken including Medline, Scopus and CINAHL. The search terms 'atrial fibrillation', 'anticoagulation', 'carer', 'caregiver', 'family support' were used. Dates searched were from January 1990 to November 2012.
  
  
  RESULTS
  The review found limited original clinical research studies. The majority of the literature identified in the initial search included review papers and work which recommends the inclusion of the caregiver in the care of patients with atrial fibrillation but limited empirical evidence.
  
  
  CONCLUSIONS
  Caregivers have an essential role to play in advocacy, family centred care and shared decision-making. This may influence thromboprophylaxis treatment choices and potentially adherence. Assessment of caregiver needs and support should be central to patient assessment and care planning. There is a need for clinical intervention studies which more target and address the caregiver role.
authors.affiliation: Centre for Cardiovascular & Chronic Care, Faculty of Health, University of Technology, Sydney, Australia caleb.ferguson@uts.edu.au.
authors.forename: Caleb
authors.initials: C
authors.lastname: Ferguson
authors.affiliation: Centre for Cardiovascular & Chronic Care, Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Sally C
authors.initials: SC
authors.lastname: Inglis
authors.affiliation: Centre for Cardiovascular & Chronic Care, Faculty of Health, University of Technology, Sydney, Australia.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Newton
authors.affiliation: St Vincent's Health Australia (Sydney); Australian Catholic University, Australia.
authors.forename: Sandy
authors.initials: S
authors.lastname: Middleton
authors.affiliation: University of New South Wales, St Vincent's Hospital, Sydney; Victor Chang Research Institute, Australia.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Macdonald
authors.affiliation: Centre for Cardiovascular & Chronic Care, Faculty of Health, University of Technology, Sydney, Australia School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D017028:Caregivers; D006801:Humans; D055118:Medication Adherence; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; caregiver; caregiver education; caregiver role; family support; stroke prevention; thromboprophylaxis