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Impact of a community anticoagulation service on the admission for stroke secondary to atrial fibrillation

Evaluating the impact of a community anticoagulation service on the admission for stroke secondary to atrial fibrillation

What we are doing:

This is an evaluation of the community anticoagulation service which provides near patient testing and monitoring. Working together, various stakeholders aim to achieve an anticoagulation service across community, primary and acute care, resulting in a more cost-effective, accessible, culturally competent and high-quality service for all patients with a reduced primary outcome of stroke. 

The evaluation of the clinical markers of time in therapeutic range (TTR), non-therapeutic INR (high and low) and significantly high INR (posing a clinical risk) will also be assessed. We shall also assess admission rates for atrial fibrillation (AF) related strokes.

Why we are doing it:

A number of areas of medical care require a multi-disciplinary approach and, or, specialist skills. For anticoagulation, these scenarios have not been formally defined as for other disciplines. However, these patients are strictly too complex to be managed in primary care and should be managed in secondary care and should be followed in the hospital haematology/ anticoagulation clinics. Successfully achieving improved patient outcomes demands not only the up-skilling of GPs and practice nurses, but on-going support from specialists in this field.

What the benefits will be:

Providing a better, safer and more extensive primary anticoagulation service will benefit patients positively in terms of reduced morbidity and mortality from stroke, and also provide safer anticoagulation (care closer to home, hence more accessible). Care closer to home will reduce health disparities (travelling problems, and familiarity thus more likely to understand local language and culture). These positive findings are likely to be implemented in other health systems (in the UK and abroad) by providing local, culturally competent community anticoagulation services within primary care, thus facilitating the left shift proposed in the NHS Five Year Forward Plan. 

Who we are working with:

  • Leicester City CCG
  • University Hospitals of Leicester NHS Trust

Study lead:

Name: Dr Sam Seidu

Role: Research Fellow

Organisation: Diabetes Research Centre, University of Leicester


Dr Tun Than,