Study protocol: the DESPATCH study: Delivering stroke prevention for patients with atrial fibrillation - a cluster randomised controlled trial in primary healthcare
2011

DESPATCH Study: Improving Stroke Prevention in Atrial Fibrillation

Sample size: 2000 publication Evidence: high

Author Information

Author(s): Melina Gattellari, Dominic Y Leung, Obioha C Ukoumunne, Nicholas Zwar, Jeremy Grimshaw, John M Worthington

Primary Institution: The University of New South Wales

Hypothesis

A higher proportion of patients with NVAF whose GPs receive the DESPATCH intervention will be prescribed oral anticoagulation compared to those whose GPs receive standard care.

Conclusion

The DESPATCH intervention aims to improve the uptake of anticoagulation in patients with atrial fibrillation, potentially reducing the risk of stroke and death.

Supporting Evidence

  • Anticoagulation reduces the risk of ischaemic stroke by 67%.
  • Warfarin reduces all-cause mortality by 26%.
  • Up to 50% of patients with NVAF are not prescribed anticoagulation.

Takeaway

This study is trying to help doctors give better medicine to older people with a heart condition to prevent strokes.

Methodology

A cluster randomised controlled trial with concealed allocation and blinded outcome assessment evaluating a multifaceted implementation strategy.

Potential Biases

Potential biases may arise from the self-reported data from GPs and the reliance on medical records for outcome assessment.

Limitations

The study may face challenges with control group contamination and the generalizability of results to other settings.

Participant Demographics

Patients over 65 years of age with nonvalvular atrial fibrillation.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI, 54% to 77%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1748-5908-6-48

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