Patients with atrial fibrillation to be targeted in stroke reduction programme

Author: Ingrid Torjesen

A programme which aims to identify patients with atrial fibrillation and ensure they are receiving appropriate anticoagulants to lower their risk of stroke has been launched by NHS England as part of its Long Term Plan.

The £9 million programme, which will run until next March, will see almost 20,000 people at higher risk of experiencing a stroke receive targeted checks and treatment and aims to prevent 700 strokes and save at least 200 lives.

NHS medical director, Professor Stephen Powis, said: “Not only is stroke one of the biggest killers in our country, but it leads to life-changing and often devastating long-term harm for many others, so by spotting the risks early, the NHS will not only prevent serious harm to the people affected, but avoid the need for aftercare which puts additional pressure on the health service.”

The programme builds on a successful pilot scheme in south London and will see clinical commissioning groups in 23 areas of the country with the highest rates of stroke receive funding to train health professionals, including specialist anticoagulation pharmacists, to identify people more likely to experience a stroke and offer preventive treatment.

Treating patients who have atrial fibrillation with anticoagulation drugs reduces the risk of stroke by two-thirds, yet only half of patients with the condition who go on to suffer a stroke have been prescribed them. People who are poorer, from black or ethnic minority backgrounds or other disadvantaged groups are more likely to be among those who go undiagnosed and untreated.

As well as being devastating for patients and their families, strokes are estimated to cost the NHS around £3 billion per year, with additional costs to the economy of a further £4 billion in lost productivity, disability and informal care. Treating someone for five years after they have a stroke can cost as much as £45,000.

Dr Matt Kearney, GP and national clinical director for cardiovascular disease prevention said: “People living with atrial fibrillation may not be aware of the serious health risks they face, which is why targeting help at those groups most at risk, will be a lifesaver. Making effective treatment available and expanding access to care across England will mean GPs and pharmacists can offer support and prevent death and long-lasting harm.”

In the pilot in south London, run by Lambeth and Southwark clinical commissioning groups (CCGs), GPs and specialist anticoagulation pharmacists reviewed 1,500 patients across 92 practices between 2015 and 2016, and 947 were identified as not currently receiving anticoagulants. In total, 1,200 of those patients are now anticoagulated, preventing an estimated 45 strokes a year. The two CCGs have since seen a 25% reduction in the rate of atrial fibrillation-related stroke.