Atrial fibrillation (AF) is a growing worldwide health problem affecting 1-2% of the population. Patients with AF are at risk of cardioembolic stroke, which are often more severe compared to other stroke aetiologies, with a greater burden of disability, dementia and death. Without effective screening and prevention strategies, the burden of stroke will continue to rise on already stretched healthcare resources.
Anticoagulation is the only proven effective method to reduce an individual’s stroke risk, however, due to the perceived increased risk of adverse complications many patients who benefit from anticoagulation do not receive it. This is highlighted by previous studies in optimising stroke prevention at Cambridge University Hospital from 2012 onwards which showed that nearly half the individuals admitted with AF in our area are not anticoagulated. In the second stage of our work, we showed that active screening in secondary care followed by collaborative communication with primary care led to more individuals being appropriately anticoagulated.
The SOS-AF project encompasses establishing a stroke prevention service based in Cambridge University Hospital. This specialist service, consisting of 2 stroke consultants, 1 registrar and 2 specialist nurses, would provide in-hospital screening for AF, initiate anticoagulation, provide specialist assessment and advice to primary and secondary care, and hold an outpatient service and an MDT to discuss stroke prevention with individuals with AF. SOS-AF will lead to increased anticoagulation rates in our region, as well as better patient understanding, and allow us to support our primary and secondary care colleagues with stroke prevention in AF.