Current prescribing of warfarin, the main anticoagulant used in the UK to prevent blood clots from forming in the heart, is only half what it should be, and prescribing the drug for all eligible patients with atrial fibrillation would save the NHS £124 million a year, with further savings to social care, according to new research.
Just over half of all AF patients are currently getting drug treatment in line with recently-updated best practice guidelines from the National Institute for Health and Care Excellence (NICE), says the research, which has been published as part of the Living Longer Lives programme run by the NHS England improvement organisation NHS Improving Quality (NHS IQ). Full implementation of the guidelines, with warfarin prescribed for all people diagnosed with AF (apart from where anticoagulants are not suitable for or declined by the patients) would avoid 11,626 strokes each year, saving 3,200 lives, it says.
Around 900,000 people in England have been diagnosed with AF, which is known to increase the risk of stroke and heart failure, and NICE’s latest guidance states that people with the condition who are assessed as having the highest risk of stroke should be offered anticoagulation.
However, data from the GRASP-AF audit tool developed by NHS IQ and supplied free to the NHS in England shows that, at present, only around half of eligible patients are being treated according to NICE guidelines. Current prescribing of warfarin is helping to prevent over 16,000 strokes per year, but the research puts the overall savings to the NHS alone of appropriate AF management with warfarin at £293 million a year, and £1.7 billion over a lifetime perspective.
Commenting on the findings, Hilary Walker, head of the NHS IQ Living Longer Lives programme, said: “we know that effective anticoagulation really reduces the risk of having a stroke. Data from the GRASP-AF tool shows us that currently not everyone is being managed as well as they should be. This is putting patients’ lives at risk and costing the NHS and social care millions of pounds every year.”
“GP practices can use the GRASP-AF tool for free to quickly identify patients who have or might have AF, and check their management plan. We encourage all GP practices not currently using GRASP-AF to download the tool and start to audit their care of people with AF,” she said.