Authors (including presenting author) :
Cheuk TS(1), Tse SY(1), Chu TK(1), Ng YS(1), Chan ML(1), Chan YH(1), Liang J(1)
Affiliation :
(1) Department of Family Medicine & Primary Health Care, Tuen Mun Hospital, New Territories West Cluster
Introduction :
Non-vitamin K Oral Anti-coagulants (NOAC) prescription for prevention of thromboembolic complications of non-valvular atrial fibrillation has been introduced in our department since August 2019.
Objectives :
1. To establish a workflow for patients requiring NOAC prescription in a primary care.
2. To describe patient characteristics and use of NOAC in our clinic.
Methodology :
All patients have their diagnoses confirmed by prior workup in hospital and with CHADSVASc score 5 or above, included from 8 primary care clinics of the New Territories West area of Hong Kong. Designated family physician assessed the patients and prescribed NOAC if indicated, followed by close monitoring. Staff education in NOAC use by cardiologist has been done, together with engaging other members of the primary care team, before implementation.
Result & Outcome :
The workflow has been agreed among staff and successfully implemented in our primary care clinic. Thirteen patients were referred to this service in the first 6 months. All of them aged >75 and have multi-morbidities. Seven of them were prescribed NOAC after consideration of contra-indication and agreement by patients. NOAC was well tolerated. No adverse effects, no thromboembolic events and no bleeding complications were observed. The service model was safe and feasible and could be extended to patients with less CHADSVASc scores.
