PubMed2002
OBJECTIVES: To evaluate the knowledge, attitudes and difficulties of family doctors in the indication of oral anti-coagulation treatment (OCT) in patients with non-valvular auricular fibrillation (NVAF). DESIGN: Transversal descriptive study.Setting. Area 11 of Madrid primary care.Participants. 250 doctors by simple randomised sampling. MAIN MEASUREMENTS: After a pilot study at a health centre, mailing of a questionnaire with a subsequent re-mailing. This collected social and personal details, knowledge of the question, attitudes and difficulties. RESULTS: 157 (62.8%) replied; 91 were women (58.0%); mean age was 39 (SD, 6.0). 97 had reviewed the question recently (61.8%). 110 thought that the anti-aggregation criteria were clear (70.1%; CI, 62.2-77.0%), 107 that the oral anti-coagulation criteria were (68.2%; CI, 60.2-75.2%), 132 that the OCT risks were (84.1%; CI, 77.2-89.2%), and 74 that risk factors of cerebrovascular accident were clear (47.1%; CI, 39.2-55.2%). Initially 96 doctors gave anti-aggregants and referred to cardiology (61.1%; CI, 53.0-68.7%), and 29 began OCT (18.5%; CI, 12.9-25.6%). 134 thought that we avoided initiating OCT (85.3%; CI, 78.6-90.3%), giving as the main reasons the difficulty of monitoring and of requesting further tests, the risks involved and OCT not being up-to-date. CONCLUSIONS: Most professionals have the criteria for OCT in NVAF clear, although they continue to avoid the initiation of OCT. The majority approach is to give anti-aggregants and refer to Cardiology, given the risk of the therapy and the difficulties involved in monitoring and requesting further tests.