Doctors and patients have different priorities regarding anticoagulation

Doctors and patients have different thresholds for acceptance of the risks of increased bleeding with antithrombotic drugs used to prevent stroke in atrial fibrillation. Previous observational studies have shown that antithrombotic drugs are underprescribed by doctors. Devereaux and colleagues (p 1218) studied the thresholds for risk of stroke and bleeding. Patients placed significantly more value on the avoidance of stroke and less value on the avoidance of bleeding than did doctors. Doctors showed little consistency as to how much risk of bleeding was acceptable. Patients' preferences should be incorporated into the decision to use these drugs in people with atrial fibrillation.

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Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study • Commentary: Varied preferences reflect the reality of clinical practice

P J Devereaux, David R Anderson, Martin J Gardner, Wayne Putnam, Gordon J Flowerdew, Brenda F Brownell, Seema Nagpal, Jafna L Cox, and Tom Fahey
BMJ 2001 323: 1218. [Abstract] [Full Text] [PDF]