Date: November 5th, 2012
One-Third of Surveyed Patients Report that Treatment Decision was Made Jointly with their Health Care Provider
WASHINGTON, D.C. (November 5, 2012) - The Alliance for Aging Research (Alliance) and the AFib Optimal Treatment Task Force announced the results of an on-line survey of patients 65+ years old, exploring their experiences with the diagnosis and treatment of their atrial fibrillation (AFib). The objectives of the survey of more than 500 AFib patients were to better understand patient experiences during diagnosis, their information sources, the dynamics of their treatment decisions, the use of anticoagulants, the assessment of stroke and bleeding risk in the treatment decision, and treatment compliance. It was also designed to complement a previous survey of health care professionals (primary care physicians, internists, and geriatricians) that found that less than 50% used stroke risk assessment tools regularly. Almost none of the patients surveyed were aware of any use of risk assessment tools by their health care professionals.
Approximately 2.6 million Americans currently have AFib; which is associated with an approximate doubling of mortality risk--primarily because of the heightened risk of stroke. The irregular heart rhythm in AFib allows blood to pool in the heart’s chambers and oftentimes clot. That clot, or thrombus, can make its way to arteries in the brain and cause a stroke. AFib is a contributory cause of death for around 99,000 Americans each year. For those that survive, the disabilities can be extreme and consequently, the cost of treating the disease is high-- around $6.65 billion in direct costs each year.
This patient survey was conducted by Edge Research and was an important effort of the AFib Optimal Treatment Task Force that was formed to reduce the burden of stroke in AFib by creating awareness of and consensus on the best practices for assessing stroke and bleeding risk in anticoagulation decision-making. The Task Force members include the Alliance for Aging Research, Anticoagulation Forum, Atrial Fibrillation Association, ClotCare, Heart Rhythm Society, Mended Hearts, Men’s Health Network, National Forum for Heart Disease and Stroke Prevention, National Stroke Association, Preventive Cardiovascular Nurses Association, Society for Women’s Health Research, and StopAfib.org. Visit the Alliance’s web site for additional information on the Task Force and its important efforts.
While most older AFib patients reported that they were diagnosed after experiencing symptoms, diagnosis at regular check-ups has increased over recent years--suggesting a positive change in the number of physicians who regularly check for the disease. 85% of patients surveyed were satisfied with their diagnostic process.
When it comes to the treatment decision, satisfaction is also high—more than two-thirds report being very satisfied. 43% report that their health care provider was the most influential in the decision and 31% report that it was a joint decision between them and their health care provider. Those who reported a joint decision also report the highest level of satisfaction. Interestingly, 38% of those patients who did their own research on the disease and its treatment still let their doctors take the reins and make the sole decision.
While few patients had health care professionals who recommended no treatment or didn’t mention anticoagulation at all, most of those on anticoagulants were given only one option. Most patients reported having had a discussion of stroke risk with their health care professional as well as a bleeding risk discussion although the number is definitely lower for the latter—73% versus 63%. Discussion of risks generally focused on modifiable risk factors like weight, high blood pressure, or poor diet.
87% of all patients surveyed visit a health care professional for their AFib a few times a year or less. Not surprisingly, monthly or more frequent doctor visits are much more likely for patients on Warfarin, because of the need for frequent INR tests. In open-ended questions about the pros and cons of their medication, the burden of monitoring was listed as a downside of Warfarin. On the other hand, cost was the most frequently mentioned downside of the new drugs.
“While this patient survey offers a hopeful look at how older Americans and their health care professionals are dealing with diagnosis and treatment of atrial fibrillation, assessment of bleeding risk remains an area where there is still some confusion among both health care professionals and patients. As new anticoagulants continue to come to market the treatment decision will become increasingly complicated, but with proper education and awareness will offer a new era of personalized medicine options in prevention of AFib related strokes,” said Daniel Perry, President & CEO of the Alliance for Aging Research.
“Science tells us that women with Afib have a much more pronounced risk for stroke, heart failure, and cardiovascular death than men. Also, these women are more likely to live with stroke-related disability than men”, said Phyllis Greenberger, MSW, president and CEO of the Society for Women’s Health Research. “Clearly, AFib is a crucial disease that women must be informed of. SWHR is happy to be a part of the AFib Optimal Treatment Task Force and will help inform women of these survey results to help them manage their care.”
For more information about atrial fibrillation and the Optimal Treatment Task Force, please visit the Alliance for Aging Research Web site at: http://www.agingresearch.org/CustomPages/view/22. To read the full survey results visit:http://www.agingresearch.org/Publications/view/51#.VFuWlPnF-2Z and to read the highlights visit:http://www.agingresearch.org/Publications/view/50#.VFuWtvnF-2Z. The efforts of the AFib Optimal Treatment Task Force are supported by an unrestricted educational grant from Daiichi Sankyo, Inc. The Alliance for Aging Research and the Task Force maintain editorial control over all products and efforts of the Task Force.
About the Alliance for Aging Research
Founded in 1986, the Alliance for Aging Research (Alliance) is a nonprofit, independent organization dedicated to improving the health and independence of aging Americans through public and private funding of medical research and geriatric education. The Alliance combines the interest of top scientists, public officials, business executives, and foundation leaders to promote a greater national investment in research and new technologies that will prepare our nation for the coming senior boom, and improve the quality of life for today's older generation. For more information, visit: www.agingresearch.org.