{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:04:57Z","timestamp":1780657497227,"version":"3.54.1"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T00:00:00Z","timestamp":1493769600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2017,9]]},"abstract":"\n Aim<\/jats:title>\n To examine the choices Canadian family medicine residents make for\n oral anticoagulation (OAC) for patients with nonvalvular atrial\n fibrillation (AF).<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n AF increases the risk of strokes. An important consideration in AF\n management is risk stratification for stroke and prescription of\n appropriate OAC. Family physicians provide the vast majority of OAC\n prescriptions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We administered a survey to residents in multiple Canadian family\n medicine training programmes. Questions explored the experiences and\n attitudes towards risk stratification and choices of OAC when presented\n with standardized clinical scenarios. In each scenario, a novel oral\n anticoagulant (NOAC) would be the preferred treatment according to the\n contemporary Canadian and European guidelines.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n A total of 247 residents participated in the survey. Most used the\n congestive heart failure, hypertension, age \u2265 75, diabetes mellitus,\n stroke or TIA (2 points) (81%) and congestive heart failure,\n hypertension, age \u2265 75 (2 points) or age 65-74 (1 point), diabetes\n mellitus, stroke or TIA, vascular disease including peripheral arterial\n disease, myocardial infarction, or aortic plaque, sex (female) (67%)\n risk stratification schemes while the preferred bleeding risk\n stratification scheme was hypertension, abnormal liver or renal\n function, stroke, bleeding, labile international normalized ratio,\n elderly (age \u2265 65), drugs or alcohol (84%). In the clinical scenarios,\n residents generally preferred warfarin in favour of NOACs, independent\n of training level. Residents ranked the risk of adverse events and the\n cost to the patient as their most and least important consideration when\n prescribing OAC, respectively. Therefore in patients with nonvalvular\n AF, Canadian family medicine residents prefer warfarin in comparison\n with NOACs despite the latest Canadian and European guideline\n recommendations. This knowledge gap may be enhanced by multiple factors,\n including a sometimes magnified fear of adverse events and a rapidly\n changing landscape in stroke prophylaxis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1463423617000196","type":"journal-article","created":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T01:47:32Z","timestamp":1493776052000},"page":"472-481","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["How do family medicine residents choose an anticoagulation regimen for\n patients with nonvalvular atrial fibrillation?"],"prefix":"10.1017","volume":"18","author":[{"given":"Payam","family":"Yazdan-Ashoori","sequence":"first","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zardasht","family":"Oqab","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William F.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran L.","family":"Quinn","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik van","family":"Oosten","sequence":"additional","affiliation":[{"name":"Western University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilma M.","family":"Hopman","sequence":"additional","affiliation":[{"name":"Queen\u2019s University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Baranchuk","sequence":"additional","affiliation":[{"name":"Queen\u2019s University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,5,3]]},"reference":[{"key":"S1463423617000196_manual_ref-4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.303211"},{"key":"S1463423617000196_manual_ref-21","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3102"},{"key":"S1463423617000196_manual_ref-17","first-page":"261","article-title":"Acute management of atrial fibrillation: Part II. 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