The relative importance of barriers to the prescription of XXXX for nonvalvular @entity955 .

@entity1 @entity64 @entity548 @entity955 @entity1229
BACKGROUND AND PURPOSE: Despite the publication of a number of randomized, controlled trials demonstrating a substantial reduction in @entity64 with anticoagulation in @entity1 with nonvalvular @entity955 , the 'real world' use of @entity1229 is sub-optimal. Previous surveys have attempted to explain this problem but have significant limitations. The purpose of this study was to assess the relative importance of various barriers that may influence the prescription of @entity1229 in @entity1 with nonvalvular @entity955 . METHODS: This cross-sectional survey was mailed to all practising cardiologists, neurologists and internists, as well as a random sample of family physicians within Alberta. Physicians caring for @entity1 with NVAF rated the relative importance of potential barriers using a Likert scale. RESULTS: Sixty-seven per cent of all physicians returned the survey. Overall, barriers pertaining to the @entity1 's clinical characteristics were rated to be more important than those pertaining to the physician or to the organization required when prescribing these therapies. Specifically, an ongoing history of falls, a history of @entity548 within the previous year and an inability to comply with therapy were rated as important barriers by 64%, 55% and 53% of physicians, respectively. Most physicians strongly believed that @entity1 should receive information on the benefits and risks of @entity1229 (96%) and that @entity1 should have a say in whether @entity1229 is prescribed (86%). IMPLICATIONS: This study suggests that most of the barriers to @entity1229 use pertain to @entity1 clinical characteristics and the need for @entity1 to be involved in the decision to initiate therapy. The use of decision support technologies would facilitate involvement of the @entity1 and serve to educate both the @entity1 and physician on the risks and benefits of @entity1229 therapy.
