New materials to support clinicians in involving intracerebral haemorrhage (ICH) patients with atrial fibrillation (AF) in the decision-making process for their treatment are now available as part of the PRESTIGE-AF project.
PRESTIGE-AF-funded research has shown that clinicians view the process of deciding on stroke prevention in patients with AF post-ICH as “challenging” due to considerable “clinical equipoise”.
“Patients with ICH were largely excluded from seminal trials on the safety and efficacy of oral anticoagulants (OAC) in patients with AF, and much of the current evidence on the use of OAC and/or antiplatelets in patients with AF and ICH comes from observational studies,” says Elena Ivany, Research Associate at the University of Liverpool’s Centre for Cardiovascular Science. “These are major factors in the uncertainty of how to treat these patients, which PRESTIGE-AF is aiming to resolve.”
Physicians who are required to advise on appropriate stroke prevention therapy for patients with AF and ICH have described a desire to involve patients in the decision-making process. However, at the same time, there is some uncertainty as to how shared decision-making is best achieved.
Developed by the University of Liverpool team, these educational materials aim to facilitate patient involvement in the decision-making process by providing physicians with a range of information that can be used during patient-facing consultations.
The materials that are included in the pack are based on key patient-related outcomes related to stroke prevention in AF, such as risk of ischaemic/thromboembolic events, risk of bleeding, and lifestyle considerations.
Physicians may wish to use the materials to initiate conversations about patients’ goals of care and to identify patients’ preferred treatments or therapies for stroke prevention. Some of the materials are interactive, while others can be used as supporting information to promote patient understanding of the benefits and risks of OAC.
Additionally, there are links to resources that physicians may wish to share with patients who are interested in learning more about their disease and the stroke prevention therapies available to them.
The materials have been peer-reviewed by physicians and patients to ensure that the information provided is clinically relevant and accurate.
Overall, it is hoped that these educational materials can be a positive tool to promoting patient engagement in discussions about stroke prevention therapy in individuals with AF and ICH.