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KMID : 1143420200130402921
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Public Health Weekly Report
2020 Volume.13 No. 40 p.2921 ~ p.2929
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The Importance of Developing a Clinical Strategy for Stroke Prevention in Patients with Atrial Fibrillation, Korea
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Shin Seung-Yong
Kim Ji-Yeon
Lee Seung-Hee
Kim Won-Ho
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Abstract
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Stroke is the second most common cause of death and the third most common cause of disability in the world. Not only is the incidence of stroke rapidly increasing, its social and economic burden is on the rise. For the prevention of stroke, a strict management of modifiable risk factors is important. Among the generally recognized risk factors, the control and management of hypertension occupies a critical part. Atrial fibrillation (AF), which is common in the transition from hypertension to stroke, is an independent risk factor that increases the risk of ischemic stroke by more than five times. Oral anti-coagulation therapy is frequently used for the purpose of stroke prevention. Studies showed that through oral anti-coagulation therapy, the risk of stroke is reduced by more than 60%, but bleeding risk potential and low prescription rates in clinical situations are problematic, and active efforts are required to improve this.
The Korea Disease Control and Prevention Agency (KDCA), and National Institute of Health (NIH) began a study to identify the factors that interfere with appropriate delivery and the implementation of guideline-based management by applying performance and quality measures. Furthermore, clinical strategies to improve the implementation rate has been ongoing since 2018.
In this study, a prospective cohort was established for patients with atrial fibrillation and atrial flutter, and the relationship between the anti-coagulant treatment rate, performance and quality measure in real-world clinical practices were examined. Based on its findings, this study made suggestions for the improvement of treatment outcomes and cost effectiveness.
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KEYWORD
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Ischemic stroke, Atrial fibrillation, Atrial flutter, Performance measure, Quality measure, Oral anti-coagulants
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