AF180° was initiated by the AF Association, AntiCoagulation Europe, the Arrhythmia Alliance, and an Alliance b
etween
Bristol-Myers Squibb Pharmaceuticals Ltd and Pfizer Ltd (the BMS-Pfizer Alliance) and is funded b
y the BMS-Pfizer Alliance.
TOP FIVE QUESTIONS TO
ASK ABOUT PREVENTING
AF-RELATED STROKE
af180.co.uk
People diagnosed with atrial fibrillation (which you may often hear referred to
as “AF”) who are considered to be at risk of having an AF-related stroke, should
be offered medicines to help prevent this. The National Institute for Health and
Care Excellence (NICE) Guideline on AF (CG180) sets out the types of medicine
that should be offered and notes that “Patients should have the opportunity to
make informed decisions about their care and treatment, in partnership with
their healthcare professionals.” 1
If you have recently been diagnosed with
AF, or even if you have been diagnosed
with AF for some time, you may find you
have questions for your doctor, nurse, or
another healthcare professional such as
your local pharmacist, about the type of
medication you have been prescribed.
If you have been diagnosed with AF and
believe you have been prescribed aspirin
in relation to your AF, you may wish to ask
your doctor if this is still appropriate for you.
However, do not stop taking any medication
you have been prescribed without speaking
to your doctor first.
NICE recommends that people at risk* of
an AF-related stroke should be prescribed
one of the following medicines which are
known as anticoagulants: 1,2
The following questions have been
prepared by our AF180 Degrees Campaign
Steering Committee of expert healthcare
professionals and patient advocates. These
are compiled from the many questions that
patients ask them but are the top questions
that our experts feel should help you get
the most from your conversation with your
doctor about medication to prevent an
AF- related stroke.
• Apixaban
• Dabigatran
• Edoxaban
• Rivaroxaban
• Warfarin
This means that you should be given a
choice of one of these medicines, if your
doctor believes that you need medicine
to prevent a potential AF-related stroke.
Not all of these medicines are appropriate
for all patients or all types of AF, so you
should discuss with your doctor which of
them may be right for you.
NICE has also recommended that
aspirin taken alone is inappropriate for
the prevention of AF-related stroke.1
If you are the family member, carer, or friend
of someone with AF, you may also want to
ask these questions on behalf of the patient.
*People with AF may be at increased
risk of blood clots. A stroke can happen
if a blood vessel in the brain is blocked
by a clot. NICE recommends that your
healthcare professional should use risk
scores to estimate your risk of stroke
and risk of bleeding.3
TOP 5 QUESTIONS
1
Does my diagnosis of AF mean that I am at risk of AF-related
stroke and how high is my risk?
2
Do I need medication to reduce my risk of an AF-related stroke?
3
What are the medication options to reduce my risk of an AF-related
stroke and what are the differences between them?
4
Are there any restrictions on my lifestyle as a result of the medication
I have been/or may be prescribed? Do I need to change my diet? Are
there certain foods, drinks, or medicines I should avoid?
5
(If you are an AF patient and think you are currently taking only
aspirin for the prevention of AF-related stroke…) Have I been
prescribed aspirin to reduce my risk of an AF-related stroke,
or for another reason?
If your doctor says that you have been prescribed aspirin
alone to reduce your risk of AF-related stroke, note the
guidance from NICE above – aspirin alone is no longer
considered an appropriate treatment for the prevention
of AF-related stroke).
TIPS TO HELP YOU PREPARE FOR A
SHARED AND INFORMED DISCUSSION
You can help prepare for a shared and informed discussion with
your doctor by using the following tips:
• Write down any questions you may want to ask before your visit;
•B
e prepared to take notes – bring a pen and paper along to the
appointment;
•C
onsider asking a partner, friend or family member
to come with you to the appointment for support;
•D
o not be frightened to say if you do not understand something, or
need to ask for something to be repeated or explained in more detail.
QUESTIONS OF YOUR OWN
You may have other questions that occur to you that you wish to write
down before your next appointment.
For example, you may have questions on:
•T
reatment options to treat the AF and its symptoms (as anticoagulants help
prevent AF-related stroke but do not treat AF itself or its symptoms)
• When your next appointments will be and where
•S
ources of further information and support, such as the AF Association
Arrhythmia Alliance, and AntiCoagulation Europe, including their local patient
support groups which may operate in your area
1. NICE, 2014. Atrial Fibrillation: the management of atrial fibrillation: NICE clinical guideline 180. Available at: https://www.nice.org.uk/guidance/CG180 (Accessed: May 2016)
2.NICE, 2015. Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation, Technology Appraisal Guidance. Available at: https://www.
nice.org.uk/guidance/ta355/resources/edoxaban-for-preventing-stroke-and-systemic-embolism-in-people-with-nonvalvular-atrial-fibrillation-82602669987781 (Accessed: May
2016) 3.NICE, 2014. Patient Decision Aid: Atrial Fibrillation: medicines to help reduce your risk of a stroke – what are the options?. Available: https://www.nice.org.uk/guidance/
cg180/resources/patient-decisionaid-243734797 (Accessed May 2016)
af180.co.uk
PP-GIP-GBR-0155
June 2016
AF A
™
www. afa.org .uk