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Clinical Effectiveness Group

Initiative to prevent strokes in east London wins first place in AF Association Healthcare Pioneers Report 2023

An initiative led by Barts Health NHS Trust, with CEG, UCL Partners and east London clinicians, is featured as the first-place winner in the AF Association Healthcare Pioneers Report 2023. The report highlights innovative approaches to detecting, protecting, correcting and perfecting atrial fibrillation management.

CEG dashboard on screen - small

Atrial fibrillation (AF) is a heart condition that causes an irregular heartbeat, blood clots and stroke. Anticoagulant medications in people with AF reduce strokes by more than half, but many people are not prescribed them. Barts Health pharmacists are leading a campaign to tackle the issue. The award-winning initiative has increased the use of life-saving anticoagulant medications, and reduced the number of patients taking both anticoagulants and antiplatelets which can pose a bleeding risk. 

The Barts Health pharmacists worked with GPs and practice pharmacists. They stratified and prioritised patients for review using the UCL Partners Proactive Care Frameworks and the CEG AF-APL tools to identify people with AF not on optimal treatment. Weekly multidisciplinary team meetings, consisting of a cardiologist, haematologist, GP and specialist pharmacist, reviewed complex patient cases and agreed action plans.

As part of the initiative, 1,579 patients were reviewed between December 2020 and March 2023, with 415 patients newly initiated on anticoagulant therapy - preventing an estimated 17 strokes. During that time, the number of patients with AF appropriately anticoagulated increased from 88% to 94%. There was also a 52% reduction in dual antithrombotic therapy (taking both anticoagulants and antiplatelets), preventing an estimated three major bleeds and improving patient safety. 

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