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Project Leader: Dr Tim Holt, NIHR Clinical Lecturer

Lack of uptake of oral anticoagulants (OAC) in people with atrial fibrillation (AF) is an important public health problem as most are at high risk of stroke, a risk substantially reduced by OAC therapy. Tim is Chief Investigator on this cluster randomised trial supported by NIHR (£610,000). He is collaborating with EMIS, the leading provider of clinical software to UK general practice. Jointly they have developed a tool that interrogates electronic records and flags up people with AF that are eligible for OAC but not taking this treatment. Forty-six practices across England will be randomised to receive or not to receive the installation of this tool. The primary outcome is the proportion of the eligible population that is receiving OAC treatment after six months. If the tool is found to be beneficial and safe it will be possible to disseminate it rapidly throughout the NHS. The project is supported by a qualitative process evaluation. 

The research team includes collaborators at Oxford, Birmingham and Nottingham Universities and the NHS. We benefit from input from the two major public charities (Arrhythmia Alliance and the Atrial Fibrillation Association) that are represented on the Trial Steering Committee.

The idea for this research came from Tim’s PhD thesis, a previous randomised trial of electronic software, a meta-analysis of electronic reminder interventions operating at the point of care, and a large UK survey of stroke risk and OAC uptake in primary care.

October 2013

photo credit: Ano Lobb via flicker cc unchanged

PP Holt pills