Canadian Community Utilization of Stroke Prevention Study

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

360 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-06-01

Study Completion Date

2018-03-08

Brief Summary

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Atrial fibrillation (AF) is a common heart condition, and increases the risk of stroke by six times. There are several medications (blood thinners) that can prevent strokes in AF patients. Many AF patients present to the emergency department, but about half of AF patients leave without prescription of a blood thinner. The study aims to evaluate if adding options like giving a patient education kit, encouraging emergency room physicians to prescribe a blood thinner and providing a specialized AF clinic to patients will increase the number patients receiving blood thinners to prevent strokes.

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Detailed Description

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This is a knowledge translation study will occur in three consecutive phases: Phase 1 is a retrospective chart review of all patients who presented to the emergency department (ED) with ECG documented AF during 1 year prior to study commencement. The main purpose of Phase 1 is to determine if oral anticoagulants (OACs) were prescribed for eligible AF patients at ED discharge. In Phase 2 a low-intensity intervention will be applied in the ED during 6 months, involving physician education, distribution of an AF patient education package, short-term OAC prescription, and a follow-up letter to the patient's family physician. After a one month transition phase, a high intensity intervention will be applied during 6 months in Phase 3. Phase 3 incorporates the Phase 2 intervention, and adds immediate follow-up (within 48-72 hours) in a community AF clinic run by a nurse/pharmacist who is supervised by a specialist in AF.

Conditions

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Atrial Fibrillation Stroke

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Phase 1: Retrospective Chart Review

Retrospective chart review of all patients who presented to the emergency department (ED) with ECG-documented AF during 1 year prior to study commencement. The main purpose of Phase 1 is to determine if oral anticoagulants were prescribed for eligible AF patients at ED discharge.

Group Type OTHER

Retrospective review of OAC prescription

Intervention Type OTHER

Phase 2: Low-Intensity Intervention

Low-intensity intervention will be applied in the ED during 6 months, involving physician education, distribution of an AF patient education package, short-term oral anticoagulant prescription, and a follow-up letter to the patient's family physician.

Group Type OTHER

Prescription of OAC in ED

Intervention Type OTHER

Phase 3: High-Intensity Intervention

Phase 3 incorporates the Phase 2 intervention, and adds immediate follow-up (within 48-72 hours) in a community AF clinic run by a nurse/pharmacist who is supervised by a specialist in AF.

Group Type OTHER

Prescription of OAC in ED

Intervention Type OTHER

Community AF clinic

Intervention Type OTHER

Interventions

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Retrospective review of OAC prescription

Intervention Type OTHER

Prescription of OAC in ED

Intervention Type OTHER

Community AF clinic

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients who present to the emergency department with electrocardiographically documented atrial fibrillation on a 12 lead ECG

Exclusion Criteria

* Prosthetic or mechanical mitral or aortic valve
* Known rheumatic heart disease
* Unable to provide informed consent
* Will be admitted to hospital
* Life expectancy of \< 6 months
* Metastatic malignancy

Eligible Sex

ALL

Accepts Healthy Volunteers

No