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Management considerations | UK | France | Netherlands | Romania |
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Organisation of treatment | 100% GP following the national guidelines (NICE 2014) | 2/3 GP, 1/3 cardiologist (Touze 2005) access to biology laboratories is quite easy (Le Heuzey et al. 2014) | GP/cardiologist set the diagnose (Willemsen 2011) (Camm 2010), anticoagulation clinics responsible for monitoring and dosing (Rosendaal 1996) | GP, medical specialist, cardiologist (Purcarea 2009) |
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Medication | VKA used in 75% of the cases of treatment with OAC (Le Heuzey et al. 2014) | VKA used in 86% of the cases of treatment with OAC (Le Heuzey et al. 2014) | NA | NOAC or VKA 28,5% Aspirin 46% (Zdrenghea 2009) |
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Available guidelines | ESC 2010, NICE clinical guideline 2006, 2014 | ESC 2010, PPSPR 2011, HAS Guide Parcours de Soins-Fibrillation atriale 2014 | ESC 2010, NHG, CBO | ESC 2006 (2010) |
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Undertreatment | 34% of AF patients with CHADsVASc >2 do not receive OAC treatment (Barra 2015; Shantsila 2015; De Wilde 2006) | More than 50% of stroke patients with AF do not receive OAC treatment (Touzé 2005, Kirchhof 2012) | Undertreatment with OAC drugs in the elderly (Willemsen 2011, Arts 2013) | Almost all categories of drugs are underused (Zdrenghea 2009; Lip 2015) |
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Detection rate | Screening programs for +65 through the GP (Fitzmaurice 2005) | Not much done (Touzé 2005) | Done aleatory, when patients present themselves with symptoms to the GP (Heemstra 2011) | Preventive measurements still lacking |
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