Letters

Anticoagulation in patients with atrial fibrillation GPs struggle to meet demand

BMJ 1994; 308 doi: http://dx.doi.org/10.1136/bmj.308.6925.415a (Published 05 February 1994) Cite this as: BMJ 1994;308:415
  1. J Shakespeare
  1. Summertown Health Centre, Oxford OX2 7BS
  2. Department of General Practice, University of Birmingham, Medical School, Birmingham B 15 2TT.

    EDITOR, - Philip M W Bath and colleagues suggested that with the expected increase in patients taking warfarin for non-rheumatic atrial fibrillation the management of long term control with anticoagulants could be devolved into the community.1 Fiona Taylor and colleagues showed that in London few patients taking anticoagulants were managed by their general practitioners and few general practitioners were keen to take on this task.2

    I am a partner in a non-fundholding training practice in north Oxford that has seven partners and 15 483 patients. In November 1993 we had 1535 patients aged 65 or over. Assuming a Framlingham distribution of atrial fibrillation,3 we should have about 80 patients over the age of 65 who ought to be given anticoagulants.

    In August 1990 an audit showed that we had 29 patients taking warfarin for a variety of indications. Of these, 22 were …

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