Anticoagulation drugs are used to treat people with atrial fibrillation (AF) which is a very common condition that makes the heart beat irregularly. The top chambers of the heart “the atria” quiver in a chaotic pattern so blood flow slows down or stagnates, which can result in clots forming. When dislodged, these blood clots can lead to strokes in people with AF.
Warfarin has been the most popular drug used to treat people with AF for over 60 years.
But since 2012 new drugs have gradually been introduced. A new NOAC (new oral anticoagulant) service was commissioned by the local GP practices to ensure the most appropriate medicine was prescribed for stroke risk reduction.
Warfarin and each of the new anticoagulants have different benefits and side effects.
The new service allows patients to be properly assessed for suitability and treatment to be individualised.
As it is a half hour consultation, patients or their carers are also fully informed about their medication. Satinder Bhandal, consultant pharmacist, and her team of specialist prescribing pharmacists introduced clinics at Wycombe Hospital and Stoke Mandeville Hospital where they review the majority of patients in Buckinghamshire who may need anticoagulation drugs for AF. This is about 200 patients a month.
According to figures released in October 2016, Chiltern CCG was third nationally in the percentage of patients with AF who are anticoagulated. Being on the right drugs to treat AF means there is a far lower number of people suffering from strokes.
Satinder, who has worked for the Trust since 2011, said: “This is a unique way of doing things, the first of its kind in the country. The success is also due to engagement from local doctors in the hospitals and GP surgeries who are identifying patients with AF and referring them to our clinics.”
As we have been so effective at anticoagulating patients in Buckinghamshire, other Trusts are looking to develop similar models to replicate the results. Buckinghamshire Healthcare NHS Trust NOAC service is actively involved in supporting other organisations with this.