Adherence Is Better when Anticoagulation for Atrial Fibrillation Is Prescribed in the ED

Whether an emergency physician should be responsible for initiating long-term anticoagulation after diagnosing atrial fibrillation is a subject of debate, especially when access to follow-up is in question. In a secondary cohort analysis of patients with primary diagnoses of atrial fibrillation at 24 emergency departments (EDs), investigators examined long-term adherence to recommended warfarin therapy among patients prescribed warfarin in the ED versus those whose warfarin prescriptions were deferred to other providers.

Of 137 eligible patients (all of whom had CHADS2 scores ≥2 and HAS-BLED scores <3), 24% received warfarin prescriptions at the index ED visit. At 1 year, 76% of these patients were still taking warfarin, versus 36% of those …