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89/Development of a non-vitamin K oral anticoagulant (NOAC) patient alert card

European Journal of Arrhythmia & Electrophysiology. 2019;5(Suppl. 1):abstr89

Introduction: Many patients are prescribed anticoagulants to prevent thromboembolism and stroke. Newer non vitamin-K oral anticoagulants (NOACs), were first used in 2008 and are an increasingly common medication. However, they may still be unfamiliar to patients and healthcare professionals. It is important for both groups to know what drug the patient is taking, why, and what to do in an emergency. It is mandated by the National Patient Safety Agency and European Society of Cardiology to provide written safety information for patients receiving anticoagulants.

We developed a standard patient alert card with the support of the North of England strategic clinical network (NESCN) to clearly provide key safety information for patients and healthcare professionals. Figure 1 provides an illustrative example. The NESCN card was launched in 2015 across the Northern region which includes over 3 million people. It was distributed to primary and secondary care pharmacists. Electronic and face to face education was carried out alongside to pharmacists, GP’s and hospital physicians. This project aims to evaluate the implementation of the alert card.

Method and Results: We gathered patient and clinical staff feedback and summarise some key findings here.

An electronic questionnaire was sent to all GP’s, secondary care physicians and secondary care pharmacists. Ninety-two percent of pharmacists recognised the alert card and reported its use at least often and 88% used it as an opportunity for patient education. Fifty-seven percent of GPs used the alert card in their practice and 57% distributed the alert card. Forty percent of secondary care physicians recognised the alert card and 23% were aware of its distribution to patients.

Eight hundred patients who received NOACs in the previous year were contacted across 8 volunteer GP practices. We had a 62% (496/800) response rate. Sixty-five percent had received an anticoagulant safety information card, of which, 62% had the NESCN alert card. Ninety-one percent of respondents thought the NESCN card was useful and 99% thought it was easy to understand.

Conclusion: The alert card was widely embedded within practice across the region and patient feedback was good. The evaluation shows a simple and inexpensive intervention delivered with no formal funding can address this patient safety concern.

A third of patients contacted who were prescribed NOAC medication were not aware of receiving any patient held information. This suggests we still have work to do to ensure all patients benefit.

Our healthcare professional survey interpretation is limited by a low response rate, particularly amongst GP’s contacted and difficulty reaching community pharmacies.

For the future, we have engaged with CCGs and secondary care trusts in the region to ensure the legacy of the project. Several local CCGs have made arrangements to procure cards. In response to requests from other regions and organisations, the card has been widely shared and implemented across many areas of the UK.

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