The oral anticoagulant dilemma

Workshop overview Atrial fibrillation (AF) has an estimated prevalence of one in ten in people over the age of 75 years. It is responsible for a five-fold increase in the risk of ischaemic stroke. Australian studies suggest the use of anticoagulant therapy for the management of AF remains under-utilised. A Medical Observer survey revealed that GPs consider they have not received enough education to prescribe the novel oral anticoagulants (NOACs). Consideration is required as to when to use warfarin, a medicine with a well-known safety and efficacy profile but which does require ongoing monitoring, and when to use the novel oral anticoagulants where monitoring is more difficult as is reversal of activity. To support practice, the Veterans’ MATES program provided a therapeutic brief to doctors, along with patient specific feedback to assist GPs to make an informed decision when considering which oral anticoagulant is most appropriate for their patients. Nearly 85% of responding doctors found the information useful and more than 90% indicated they had learnt new information about anticoagulants. This workshop will use the Veterans’ MATES materials to highlight the place of warfarin and the novel anticoagulants therapies in practice, the importance of careful patient and therapeutic selection, the need for regular monitoring, and on-going patient education. The workshop will present the theoretical information required for participants to work through a series of case studies. Each case study will be followed by open group discussion.