Physicians' Attitudes Toward Anticoagulant Therapy in Patients with Chronic Atrial Fibrillation
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概要
- 論文の詳細を見る
Introduction Although many clinical trials have demonstrated that anticoagulant therapy substantially reduces the risk of ischemic stroke in patients with atrial fibrillation (AF), some physicians are reluctant to use anticoagulants. We investigated attitudes of physicians in Japan toward anticoagulant therapy in chronic AF patients. Methods We conducted a survey at the annual meeting of the Japanese Society of General Medicine. We presented subject physicians with 8 vignettes of chronic AF patients and requested that they indicate their most favored choice of therapy from among 6 strategies including warfarin and aspirin. Results We distributed 209 questionnaires and received 139 replies (67% response rate). For all 8 vignettes presented, only 26% of the respondents preferred to use anticoagulant therapy in AF patients. Longer clinical experiences and responsibility at a teaching hospital were associated with negative attitude toward anticoagulant therapy, while experience of preventive therapy in patients with thromboembolism due to AF and strong influence of clinical trials of anticoagulant prophylaxis on their practice were associated with positive attitude toward the therapy. Among patient characteristics in the vignettes, a risk of thromboembolism was positively associated with preference for anticoagulant therapy, but an advanced age and a risk of bleeding complications were negatively associated with the preference for the therapy. Conclusions The physicians in Japan in this survey, especially those with longer clinical experiences or responsibility at a teaching hospital, have a negative attitude toward anticoagulant therapy in chronic AF patients. An advanced age and a risk of bleeding complications of patients are deterrent factors to the use of anticoagulant therapy.
- 社団法人 日本内科学会の論文
- 2004-07-01
著者
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Fukui Tsuguya
聖路加国際病院 一般内科
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Fukui T
St. Luke's International Hospital
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MAEDA Kenji
Departments of Biochemistry and Neurosurgery, Saga Medical School
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SATO T.
Department of Biostatistics, Graduate School of Medicine, Kyoto University
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YAMASHIRO Seiji
Department of General Medicine, Saga Medical School
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Hayano Keiko
Department of General Medicine, Kumamoto University School of Medicine
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MAEDA Kenji
Osaka Medical Center for Health Science and Promotion
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HIRA Kenji
Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medici
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Fukui Tsuguya
Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicin
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SAKAI Tatsuya
Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medici
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BITO Seiji
Department of General Internal Medicine, National Tokyo Medical Center
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ASAI Atsushi
Department of Biomedical Ethics, Kyoto University School of Public Health
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MATSUMURA Shinji
International Research Center for Medical Education, University of Tokyo
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Hayano Keiko
Department Of General Medicine Kumamoto University School Of Medicine
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Fukui Tsuguya
Department Of Clinical Epidemiology Kyoto University Graduate School Of Medicine
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Matsumura Shinji
International Research Center For Medical Education University Of Tokyo
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Sakai Tatsuya
Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicin
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Bito Seiji
Department Of General Internal Medicine National Tokyo Medical Center
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Bito Seiji
Department Of General Internal Medicine National Hospital Organization Tokyo Medical Center
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Hira Kenji
Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicin
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Asai Atsushi
Department Of Biomedical Ethics Kyoto University School Of Public Health
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Yamashiro Seiji
Department Of General Internal Medicine Saga Medical School
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Yamashiro Seiji
Department Of General Medicine Saga Medical School
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Sakai Tatsuya
Department Of Biological Sciences Graduate School Of Science University Of Tokyo:(present Address)de
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Fukui Tsuguya
Center For Clinical Epidemiology St. Luke's Life Science Institute St. Luke's Internationa
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Sato T.
Department Of Epidemiology And Biostatistics Kyoto University School Of Public Health
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Fukui Tsuguya
Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicin
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Asai Atsushi
Department Of Bioethics Kumamoto University Graduate School Of Medical Science
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Bito Seiji
Department Of Clinical Epidemiology National Hospital Organization Tokyo Medical Center
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Maeda Kenji
Departent Of Cardiology Kobe General Hospital
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Sato T.
Department Of Anatomy Hiroshima University Of Medicine
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Hira Kenji
Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicine
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Sakai Tatsuya
Department Of Applied Chemistry Faculty Of Science And Engineering Chuo University
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