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Rapid rollout of DOACs for AF ‘six years ahead of target’

Rapid rollout of DOACs for AF ‘six years ahead of target’
By Emma Wilkinson
2 November 2023

A rapid rollout of direct oral anticoagulants (DOACs) for people with atrial fibrillation (AF) has saved thousands of lives and is six years ahead of target, NHS England has said.

In a keynote speech to The King’s Fund annual conference today, NHS chief executive Amanda Pritchard will highlight estimates that almost 17,000 strokes had been prevented in the past 18 months.

The NHS drive to rapidly expand the use of DOACs included a new Investment and Impact Fund (IIF) indicator for 2022/23 to encourage GPs to consider switching all patients on DOACs onto edoxaban to save costs.

Some had warned the move would be time-consuming for PCNs but thresholds were revised, which seemed to alleviate some of the concerns.

At a board meeting earlier this month, increased use of DOACs was cited as one reason for an increase in prescribing costs in primary care but the NHS said commercial deals struck on the drugs had led to millions of pounds of savings.

Latest NHS figures show that since January 2022, around 460,000 more people have started taking anticoagulant drugs with more than 24 million prescriptions given to patients – preventing an estimated 17,000 strokes and 4,000 deaths.

The drive followed NICE guidance recommending four DOACs as clinical and cost-effective treatments with NHS commissioning guidance in January 2022, stating edoxaban should be the preferred option.

In 2019 a target of treating 90% of patients with atrial fibrillation with DOACs by 2029 was set but this has already been reached Ms Pritchard.

Part of the work has been around partnerships between the health service and pharmaceutical industry to increase opportunistic testing, NHS England said.

This includes £45m invested in ‘Detect, Protect, Perfect’ initiatives for local NHS teams to launch innovative schemes to diagnose and treat patients with atrial fibrillation.

One such initiative launched at 12 GP practice sites in Leicestershire enables patients to opportunistically test for atrial fibrillation using a handheld device while they sit in the waiting room.

‘Thanks to hardworking NHS teams across the country, the rapid roll-out of these drugs is a monumental step forward in providing the best possible care for patients with cardiovascular conditions,’ Ms Pritchard said.

‘It is also part of a major NHS drive to prevent ill health in the first place – we want to reduce the number of people living with major illness and save thousands more lives and from the rollout of these drugs to blood pressure checks in barber shops and supermarkets, we are ensuring we are doing all we can to achieve this.’

Professor Azeem Majeed, a GP and professor of primary care and public health at Imperial College London, said the rapid deployment of DOACs was a very positive step in cardiovascular disease management.

‘Meeting a national public health target six years early is a testament to the hard work of primary care and hospital teams.

‘The achievement showcases a successful implementation of evidence-based intervention on a large scale and reaffirms the role of the NHS as a leader in healthcare innovation and preventive medicine.

He added: ‘The innovative methods used to achieve the target could also be applied to other areas of prevention and chronic disease management.’

This article first appeared on our sister title, Pulse

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