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© 1998 Oxford University Press

research-article

The effect of age and quality of life on doctors' decisions to anticoagulate patients with atrial fibrillation

MARK SUDLOW1,2,, RICHARD THOMSON2, HELEN RODGERS1,2, STELLA LIVINGSTONE1,2 and ROSE ANNE KENNY1

1Department of Medicine, The Medical School, University of Newcastle upon Tyne Newcastle upon Tyne NE2 4HH, UK
2Department of Epidemiology and Public Health, The Medical School, University of Newcastle upon Tyne Newcastle upon Tyne NE2 4HH, UK

Address correspondence to: M. Sudlow. Fax: (+44) 191 222 6043. E-mail marksudlow{at}newcastle.ac.uk

INTRODUCTION:: we report the results of a questionnaire survey into the effect of patients' age and of medico-social factors on hospital consultants' and general practitioners' reported use of warfarin anticoagulation to treat patients with non-valvular atrial fibrillation (NVAF).

METHODS:: half of the general practitioners (n= 824) and all consultants in specialities likely to be involved in treating such patients (n= 207) in the former Northern Region were sent questionnaires asking for their views on the treatment of patients with atrial fibrillation using anticoagulants

RESULTS:: the response rate was 56% (459/824) for general practitioners and 76% (163/207) for consultants. A patient's age was of significance to many clinicians. Forty-six percent of consultants and 43% of general practitioners felt that no patient above the age of 84 years should be treated. Medico-social factors also had an important effect on whether clinicians felt patients ought to be treated with anticoagulants. A patient's quality of life was the most important medico-social factor, with handicap and place of residence having much smaller effects.

CONCLUSIONS:: age and medico-social factors have an important effect on clinicians use of anticoagulants in NVAF and reluctance to treat elderly subjects is likely to explain much of the apparent under-use of this treatment.

Keywords: age factors, anticoagulants, atrial fibrillation, cerebral embolism and thrombosis, cerebrovascular disorders, physicians practice patterns, quality of life, warfann

Received February 27, 1997;
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