The impact of substituting Warfarin with DOACs in AF patients over 65

• Research type

  Research Study

• Full title

  A study of the impact of substituting Warfarin with Direct Oral Anticoagulants (DOAC), in Atrial Fibrillation (AF) patients over 65 years old:– the Patients’ and Clinicians’ Perspectives.

• IRAS ID

  196397

• Contact name

  Patricia Maitland

• Sponsor organisation

  University of Westminster

• Duration of Study in the UK

  1 years, 0 months, 1 days

• Research summary

  A study of the impact of substituting Warfarin with Direct Oral Anticoagulants (DOAC), in Atrial Fibrillation (AF) patients over 65 years old:– the Patients’ and Clinicians’ Perspectives.

  The 3rd most common chronic illness in patients over 65 in the UK is Atrial Fibrillation (AF), which occurs when the normal electrical impulses in the heart are disrupted, resulting in a fast irregular beat, stasis of the blood and clot formations in the heart, this often leads to a stroke which is a reduction in blood and nutrients to the brain. For 60 years, Warfarin has been the only lifelong treatment for AF. Warfarin requires regular monitoring at an anticoagulation clinic interacts with most drugs and is difficult to regulate. In 2010 new Direct Oral Anticoagulants (DOACs) were approved for use as a substitute for warfarin in AF patients. DOACs require no monitoring and they do not react with other medication.
  There is however, no monitoring or antidote for DOACs and patients are switched to DOAC from warfarin are done so using the CHA2DS2-VASc and HAS-BLED scoring system as a guide. There are currently no published short or long term Quality of life or patient perception studies which include patients >65 on DOACs
  A WHO approved short form questionnaire (SF-36), as well as a perceived stress scale (PSS) will be used for a target of 50 patients. This will be conducted over a period of 18 months with patients assessed at switch, 30 days and 90 days. A focus group of clinicians, pharmacists and medical scientists involved in the prescription, dispensing and testing of these anticoagulant drugs, will be conducted to assess their knowledge of the social aspect and quality of life changes that occurs post switching anti-coagulation medication in patients over 65.

• REC name

  London - Bromley Research Ethics Committee

• REC reference

  17/LO/0290

• Date of REC Opinion

  24 Oct 2017

• REC opinion

  Further Information Favourable Opinion