Improving Stroke Prevention in Atrial Fibrillation Through Pharmacist Prescribing

• Status: Recruiting
• Trial end date: 2023-09-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to compare the effectiveness of prescribing oral anticoagulation therapy by pharmacist intervention compared to enhanced usual care in participants with unrecognized AF and/or known AF but not taking blood thinners.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Alberta
• Collaborators: Canadian Stroke Prevention Intervention Network; Heart and Stroke Foundation of Canada
• Treatments: Anticoagulants; Warfarin

Criteria

Inclusion Criteria:

• Age ≥ 65 years with one additional stroke risk factor (hypertension, diabetes, heart failure history of or left ventricular ejection fraction <0.40), previous stroke or transient ischemic attack).

• Atrial fibrillation and not on oral anticoagulation (OAC) therapy but eligible

• Atrial fibrillation on sub-optimal OAC

Exclusion Criteria:

• Uncontrolled hypertension (defined as average SBP ≥ 160 mmHg [2 readings taken at time of screening]).

• End stage renal disease (CrCl < 15 ml/min)

• Valvular Heart Disease including those with prosthetic valve, mitral stenosis (moderate to severe) or valve repair.

• Excess alcohol intake (males: ≥ 28 units/week, females: ≥ 21 units/week. One unit of alcohol = 8 oz beer, 1 oz hard liquor or 4 oz wine).

• Intracranial bleed at any point.

• History of "Major Bleeding" at any point (defined as overt bleeding at a critical site including intracranial, intraspinal, intraocular, pericardial, or retroperitoneal; or bleed requiring hospitalization).

• Foreshortened life-expectancy or severe comorbidities precluding study follow-up period

• Unable to read/understand English

• Severe cognitive impairment (defined as score ≥ 5 on the Short Portable Mental Status Questionnaire)