Patients with irregular heart rhythm more likely to stay on medication when prescribed by emergency medicine doctor
One complication of atrial fibrillation, a type of irregular heart rhythm, is higher likelihood of stroke. This threat can be curbed, however, if people with the condition take blood thinners—the risk of stroke is reduced by about 60%. As a new study headed by Sunnybrook Research Institute (SRI) scientists suggests, the person who prescribes blood thinners greatly affects whether a person takes, and stays on, medication.
Dr. Clare Atzema, a scientist in the Tory Trauma Research Program, and Dr. Peter Austin, a senior scientist in the Schulich Heart Research Program, both at SRI, led a study looking at atrial fibrillation patients between 2009 and 2014 at 15 Ontario hospitals. The 2,132 patients whose data they assessed were aged 65 years and older. With age, the risk of atrial fibrillation increases, as it does with diabetes, high blood pressure and heart disease.
They found about 68% of patients who were prescribed blood thinners by an emergency department (ED) physician were taking the medication six months later. In contrast, about 37% of patients who were told to consult their family doctor for a prescription were taking blood thinners one-half year later. Atzema and Austin, both senior core scientists at the Institute for Clinical Evaluative Sciences, the source of the data, also noted that about 75% of patients who were prescribed drugs in the ED filled their scripts within two days of discharge.
The results of the study emphasize the tendency for people to be influenced by an ED doctor’s recommendation. The team suggests these physicians consider prescribing blood thinners to the atrial fibrillation patients they see. To address a possible side effect of blood thinners, which is risk of bleeding, the authors say ED doctors should prescribe the medication short-term, but then leave it to the patient’s family doctor to determine whether continuing the therapy is appropriate.
The study was published in the Canadian Medical Association Journal.
