M. Sudlow et al., THE EFFECT OF AGE AND QUALITY-OF-LIFE ON DOCTORS DECISIONS TO ANTICOAGULATE PATIENTS WITH ATRIAL-FIBRILLATION, Age and ageing, 27(3), 1998, pp. 285-289
Introduction: we report the results of a questionnaire survey into the
effect of patients' age and of medico-social factors on hospital cons
ultants' and general practitioners' reported use of warfarin anticoagu
lation to treat patients with non-valvular atrial fibrillation (NVAF).
Methods: half of the general practitioners (n = 824) and all consulta
nts in specialities likely to be involved in treating such patients (n
= 207) in the former Northern Region were sent questionnaires asking
for their views on the treatment of patients with atrial fibrillation
using anticoagulants. Results: the response rate was 56% (459/824) for
general practitioners and 76% (163/207) for consultants. A patient's
age was of significance to many clinicians. Forty-six percent of consu
ltants and 43% of general practitioners felt that no patient above the
age of 84 years should be treated. Medico-social factors also had an
important effect on whether clinicians felt patients ought to be treat
ed with anticoagulants. ii patient's quality of life was the most impo
rtant medico-social factor, with handicap and place of residence havin
g much smaller effects. Conclusions: age and medico-social factors hav
e an important effect on clinicians use of anticoagulants in NVAF and
reluctance to treat elderly subjects is likely to explain much of the
apparent under-use of this treatment.