Xiaomei Chen
Rotherham General Hospital, United Kingdom
Abstract Title:
Improving Thromboprophylaxis in Newly Diagnosed Atrial Fibrillation in an Acute Medical Unit: A Quality Improvement Project
Biography:
Dr. Xiaomei Chen, MBBS, MRCP(UK), is an Internal Medicine Trainee (IMT) at Rotherham General
Hospital. With a dedicated interest in clinical governance and cardiology, she has completed several
Quality Improvement Projects (QIPs). Her recent project focused on improving thromboprophylactic
therapy for patients with newly diagnosed atrial fibrillation.
Research Interests:
Background: Inappropriate antithrombotic therapy in patients with newly diagnosed atrial
fibrillation (AF) increases the risk of both stroke and bleeding. This is particularly relevant in the
acute medical unit (AMU), where an increasing number of patients are first diagnosed with AF.
The updated 2021 NICE guideline on AF thromboprophylaxis recommends anticoagulation for
all eligible patients based on the CHA₂DS₂‑VASc score and the use of a bleeding risk assessment
tool, such as the ORBIT score, to guide safe prescribing.
Aim: To improve adherence to NICE guidelines on thromboprophylactic therapy in patients
with newly diagnosed AF through risk-based assessment.
Methods: Electronic care records were reviewed to identify AMU patients with a new diagnosis
of AF and their corresponding thromboprophylaxis prescriptions. Guideline recommendations
were disseminated to AMU clinicians and subsequently across the trust through educational
sessions and awareness campaigns. A re-audit was conducted to evaluate changes in compliance.
Results: In the baseline audit (November 2022), 31 patients were reviewed. Compliance with
antithrombotic prescribing according to CHA₂DS₂‑VASc score was 87%. Following interventions,
compliance improved to 91% one year later. Use of the ORBIT score for bleeding risk assessment
also increased markedly from 19% to 48%.
Conclusion: Regular communication of updated guidelines and educational interventions
significantly improved compliance with thromboprophylaxis in newly diagnosed AF patients.
Enhanced use of bleeding risk assessment tools was also achieved. Continued monitoring and
reinforcement are essential to sustain these improvements.
