Atrial Fibrillation
Conditions
Keywords
Atrial fibrillation, Frail Elderly, Anticoagulants, Platelet Aggregation Inhibitors, Multidisciplinary team
Brief summary
Antithrombotic drugs, which include antiplatelet and anticoagulant therapies, are used to prevent and treat many cardiovascular disorders. With the increase in prevalence of cardiovascular diseases and medical progress, these treatments are increasingly being prescribed, particularly in older patients. One of the main indications of antithrombotic drugs is atrial fibrillation (AF), a disease highly prevalent in older people, a population at high risk of adverse drug events. Notably, antithrombotic drugs are the first involved in serious adverse drug events, among which 40-70% may be preventable. In this context, six units of the hospital group Assistance Publique - Hôpitaux de Paris have created a multidisciplinary team which assesses antithrombotic prescriptions in older patients with AF. This team, gathering geriatricians, cardiologists, neurologists and haematologist specialized in haemostasis, evaluates the patient medical profile and suggests the most appropriate antithrombotic treatment based on their expertise and the available recommendations. Here we want to look at patients outcomes in light of the intervention of this multidisciplinary team.
Detailed description
The primary objective of this study is to evaluate the impact of the multidisciplinary team on the composite outcome of all-cause mortality, ischemic event or bleeding event at 3 months. Secondary objectives are to evaluate this composite outcome at 6 months and all-cause mortality, occurrence of ischemic event, occurrence of bleeding event, at 3 and 6 months.
Interventions
OTHERStandard of care, with intervention of the multidisciplinary team
Patients with AF, aged of 75 years or more, with evaluation of their antithrombotic treatment by the multidisciplinary team. The review of patient's file by the multidisciplinary team is based on physician decision. These patients are hospitalized in one of the 6 geriatrics units participating in the study and / or are hospitalized in another ward but their clinical file is reviewed by the multidisciplinary team.
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
75 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 75 years old patients or more * Diagnosis of AF * Hospitalized in one of the 6 geriatrics unit participating in the study and / or whose clinical file is reviewed by the multidisciplinary team
Exclusion criteria
* opposition to data collection for research purposes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite outcome of all-cause mortality, ischemic event or bleeding event | 3 months after inclusion | All-cause mortality will be assess using patient's medical record or reported death by the referent general practitioner. Ischemic events include acute coronary syndrome, transient ischemic stroke or permanent ischemic stroke, arterial embolism, deep vein thrombosis and pulmonary embolism. Bleeding events include any bleeding event requiring a medical consult or a hospitalization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause mortality | 3 months after inclusion | All-cause mortality will be assess using patient's medical record or reported death by the referent general practitioner. |
| Ischemic event | 3 months after inclusion | Ischemic events include acute coronary syndrome, transient ischemic stroke or permanent ischemic stroke, arterial embolism, deep vein thrombosis |
| Bleeding event | 3 months after inclusion | Bleeding events include any bleeding event requiring a medical consult or a hospitalization. |
| Composite outcome of all-cause mortality, ischemic event or bleeding event | 6 months after inclusion | All-cause mortality will be assess by patient's medical record or reported death by the referent general practitioner. Ischemic events include transient ischemic attack or ischemic stroke, arterial embolism, deep vein thrombosis and pulmonary embolism. Bleeding events include any bleeding event requiring a medical consult or a hospitalization. |
Countries
France
Outcome results
None listed