TY - JOUR
T1 - A call for appropriate evidence and outcomes-based use and measurement of anticoagulation for atrial fibrillation
T2 - Moving the population towards improved health via multiple stakeholders
AU - Kountz, David S.
AU - Shaya, Fadia T.
AU - Gradman, Alan H.
AU - Puckrein, Gary A.
AU - Kim, Michael H.
AU - Wilbanks, Jennifer
AU - Stevenson, James G.
AU - Larsen, David L.
AU - Wysong, Michael
AU - Chirikov, Viktor
AU - Pan, Wayne T.
AU - Xu, Liou
N1 - Publisher Copyright:
© 2015, Academy of Managed Care Pharmacy.
PY - 2015
Y1 - 2015
N2 - A multidimensional approach involving consideration of available resources, individual patient characteristics, patient preferences, and cost of treatment is often required to optimize clinical decision making in the management of atrial fibrillation (AF). In order to bring together varying perspectives on effective tactics and to formulate innovative strategies to improve the management of AF, a think tank consortium of advisors was assembled from across the spectrum of health care stakeholders. Focus groups were conducted and facilitated by a moderator and a notetaker. Participants were asked to comment on preliminary data for the increased prevalence of AF, patterns of treatment, impact of adherence with anticoagulants on clinical and economic outcomes, and opportunities for optimizing treatment. Several recommendations to reach short- and long-term goals in improving AF management emerged from the focus group discussions. These recommendations specifically targeted 3 stakeholder groups- patients/caregivers, physicians, and payers-and addressed the need for better understanding of determinants of undertreatment and nonadherence for those on anticoagulation therapy. Recommendations included the use of real-world data studies to understand regional and demographic patterns of treatment and outcomes, the development of an enhanced national quality standard for anticoagulation, and engaging patients in shared decision making to optimize satisfaction with treatment. Actionable strategies were presented to address gaps related to anticoagulation management. Balancing new anticoagulants' higher prescription costs and safety concerns with their superior effectiveness and convenience of administration for at-risk individuals would require a concerted effort involving patients and their caregivers, physicians, and payers.
AB - A multidimensional approach involving consideration of available resources, individual patient characteristics, patient preferences, and cost of treatment is often required to optimize clinical decision making in the management of atrial fibrillation (AF). In order to bring together varying perspectives on effective tactics and to formulate innovative strategies to improve the management of AF, a think tank consortium of advisors was assembled from across the spectrum of health care stakeholders. Focus groups were conducted and facilitated by a moderator and a notetaker. Participants were asked to comment on preliminary data for the increased prevalence of AF, patterns of treatment, impact of adherence with anticoagulants on clinical and economic outcomes, and opportunities for optimizing treatment. Several recommendations to reach short- and long-term goals in improving AF management emerged from the focus group discussions. These recommendations specifically targeted 3 stakeholder groups- patients/caregivers, physicians, and payers-and addressed the need for better understanding of determinants of undertreatment and nonadherence for those on anticoagulation therapy. Recommendations included the use of real-world data studies to understand regional and demographic patterns of treatment and outcomes, the development of an enhanced national quality standard for anticoagulation, and engaging patients in shared decision making to optimize satisfaction with treatment. Actionable strategies were presented to address gaps related to anticoagulation management. Balancing new anticoagulants' higher prescription costs and safety concerns with their superior effectiveness and convenience of administration for at-risk individuals would require a concerted effort involving patients and their caregivers, physicians, and payers.
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U2 - 10.18553/jmcp.2015.21.11.1034
DO - 10.18553/jmcp.2015.21.11.1034
M3 - Comment/debate
C2 - 26521115
AN - SCOPUS:84946397419
VL - 21
SP - 1034
EP - 1038
JO - Journal of managed care & specialty pharmacy
JF - Journal of managed care & specialty pharmacy
SN - 2376-0540
IS - 11
ER -