Optimising clinical effectiveness and quality along the atrial fibrillation anticoagulation pathway through implementation of personalised care

Goal: To evaluate and disseminate lessons learnt from the optimisation of the entire AF anticoagulation pathway in the Newcastle area. The redesigned pathway will improve the quality of patient care, personalisation and clinical effectiveness.

 

Project description: An innovative new clinical pathway for Atrial Fibrillation will improve patient treatment stratification and personalisation of care. At the start of the pathway, genetic testing will identify warfarin sensitivity and shared decision-­‐making will enable health professionals and patients to make an informed choice of anticoagulant. Two cohorts of individuals  (see target population) will be offered INR self-­‐monitoring using point of care coagulometers and telehealth solutions. Project learning will be shared through webinars and workshops, and the creation of an open source economic model that will enable localities across England to quantify potential cost-­‐benefits of pathway optimisation.

 

Target population: The project will focus on two cohorts, the first drawn from the estimated 650 newly diagnosed AF patients in the Newcastle upon Tyne area; the second a stratified sample of existing attendees at Newcastle warfarin clinics in hospital, community settings and in domiciliary care.

 

Methods: Patient’s genetic, anthropometric and TTR data will be recorded and analysed. Qualitative data will be collected from patients, clinical staff, healthcare professionals, commissioners and other stakeholders.

 

Assessment: As the new pathway is operationalised, resource use, patient experience and clinical outcomes will be collected. A de novo economic model will be developed to allow commissioners across England to calculate the cost-­‐effectiveness of implementing the new pathway in their area.