Improving the management of Atrial Fibrillation in General Practice: protocol for a mixed method study (Preprint)

UNSTRUCTURED Background: Atrial fibrillation (AF) is one of the commonest arrhythmias seen in general practice. The thromboembolic complications of AF include Transient Ischemic Attack (TIA), stroke and pulmonary embolism. Early recognition of AF can lead to early intervention with managing the risks of these complications. Objective: The primary aim of this study is to investigate if patients are currently being managed in general practice according to current national guidelines. In addition, the study will evaluate the impact of direct oral anticoagulant use with respect to AF complications in a real-world dataset. The secondary aims of the study are to develop a dashboard that will allow monitoring the management of AF in general practice and evaluate the usability of the dashboard. Methods: The study will be conducted in two phases: (1) The initial phase is a quantitative analysis of routinely collected primary care data from the Oxford Royal College of General Practitioners Research and Surveillance Center (RCGP RSC) sentinel network database. AF cases will be identified from 2009-2019. The study will investigate the impact of the use of anticoagulants on complications of AF over this time period. We will use this dataset to examine how AF was managed in primary care during the last decade. (2) The second phase will involve development of an online dashboard for monitoring management of AF in general practice. We will conduct a usability evaluation for the dashboard identify usability issues and perform enhancements to improve usability. Planned outputs: Findings from the study will be submitted for publication in peer-reviewed journals to report quantitative and qualitative aspects of the study., Funding: Funding for study by Daiichi Sankyo.