Guideline Adherence As An Indicator of the Extent of Antithrombotic Overuse and Underuse: A Systematic Review

Magnolia Cardona, Louise Eisten Craig, Mark A. Jones, Oyuka Byambasuren, Mila Obucina, Laetitia Hattingh, Justin Clark, Paul P Glasziou, Tammy C Hoffmann

Research output: Contribution to journalReview articleResearchpeer-review

5 Downloads (Pure)

Abstract

Thromboembolic events are a common risk in adults with atrial fibrillation, those with previous cerebrovascular accidents and undergoing emergency or elective surgeries. The widespread availability of antithrombotic agents and differing guidelines contribute to practice variations and increased risk of complications and deaths. The objective of this review was to investigate the extent of overuse and underuse of antithrombotics for primary or secondary prevention as measured by deviation from prescribing guideline recommendations. We conducted a systematic review of Medline and EMBASE for quantitative articles published between 2000 and 2021 and used a modified version of the Hoy’s risk of bias assessment tool. Here we report evidence from the past decade about wide practice variations in hospitals and primary care, and discuss clinician and patient-driven determinants of non-adherence to guidelines. Finally, we summarise implications for practice, identify enhanced ways of measuring overuse and underuse, and propose potential solutions to the measurement challenges.
Original languageEnglish
Article number55
Pages (from-to)55
Number of pages1
JournalGlobal Heart
Volume17
Issue number1
DOIs
Publication statusPublished - 12 Aug 2022

Fingerprint

Dive into the research topics of 'Guideline Adherence As An Indicator of the Extent of Antithrombotic Overuse and Underuse: A Systematic Review'. Together they form a unique fingerprint.

Cite this