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Page 36
Volume 2
Journal of Molecular Cancer
Cancer & Primary Healthcare 2019
May 20-21, 2019
Cancer Research & Oncology
Primary Healthcare and Medicare Summit
May 20-21, 2019 | Rome, Italy
25
th
Global Meet on
World Congress on
&
Notes:
How routine is follow-up monitoring of atrial fibrillation patients prescribed direct oral
anticoagulants? ACase study of Irish GPs using a count model
Ann Kirby, Aileen Murphy, Colin Bradley
University College Cork, Ireland
Background:
Direct Oral Anticoagulants (DOACs) are widely marketed as medicines that don’t require
routine laboratory monitoring. However, owing to their complex pharmacological properties and side effects
prescribing and monitoring guidelines have emerged. These advocate monitoring for renal and hepatic
impairment; bleeding episodes; liver function; co-medication; circulation and occurrence of side effects.
Though advocated, follow-up is currently not routine and its implementation creates an externality for general
practitioners (GP)s managing Atrial Fibrillation (AF) patients in the community.
Objectives:
This study investigates the frequency, the type of follow-up, and the factors that influence follow-
up amongst Irish GPs, who prescribe DOACs to patients with AF, to prevent strokes.
Methods:
The frequency and type of follow-up care is estimated and a count model is applied to determine
the GP and practice characteristics that influence the implementation of follow-up.
Results:
The most frequently observed guidelines are those pertaining to renal function (82%), bleeding
episodes (71%), liver function (69%), circulation (54%) and side-effects (55%). The regression analysis
revealed that female GPs (P=0.05) and GPs who observe all seven guidelines (P=0.06), practice more frequent
follow-up while those in training practices (P=0.09) provide less frequent follow-up.
Conclusions:
Results show that there is a lack of adherence to prescribing guidelines with only 24% adhering
to all seven guidelines and infrequent patient follow-up. Results indicate that existing education and decision
support tools are not being incorporated into routine workflows for GPs managing AF patients prescribed
DOACs.
Conclusions:
Metformin succeeded to limit weight gain the obese with pregnancy.
a.kirby@ucc.ieJ Mol Cancer, Volume 2