Multidisciplinary Team Approach to Prescribe Antithrombotic Therapy in Older People With Atrial Fibrillation

NCT04932603 | Completed

• 1 other identifier: APHP210392
• Study Type: observational
• Target: 833
• Locations: 1 country
• Sites: 1

Brief Summary

Antithrombotic drugs, which include antiplatelet and anticoagulant therapies, are used to prevent and treat many cardiovascular disorders. With the increase in prevalence of cardiovascular diseases and medical progress, these treatments are increasingly being prescribed, particularly in older patients. One of the main indications of antithrombotic drugs is atrial fibrillation (AF), a disease highly prevalent in older people, a population at high risk of adverse drug events. Notably, antithrombotic drugs are the first involved in serious adverse drug events, among which 40-70% may be preventable. In this context, six units of the hospital group "Assistance Publique - Hôpitaux de Paris" have created a multidisciplinary team which assesses antithrombotic prescriptions in older patients with AF. This team, gathering geriatricians, cardiologists, neurologists and haematologist specialized in haemostasis, evaluates the patient medical profile and suggests the most appropriate antithrombotic treatment based on their expertise and the available recommendations. Here we want to look at patients outcomes in light of the intervention of this multidisciplinary team.

Conditions

Atrial Fibrillation

Keywords

Atrial fibrillation; Frail Elderly; Anticoagulants; Platelet Aggregation Inhibitors; Multidisciplinary team

Outcome Measures

Primary Outcomes (1)

• Composite outcome of all-cause mortality, ischemic event or bleeding event

  All-cause mortality will be assess using patient's medical record or reported death by the referent general practitioner. Ischemic events include acute coronary syndrome, transient ischemic stroke or permanent ischemic stroke, arterial embolism, deep vein thrombosis and pulmonary embolism. Bleeding events include any bleeding event requiring a medical consult or a hospitalization

  3 months after inclusion

Secondary Outcomes (7)

• All-cause mortality

  3 months after inclusion

• Ischemic event

  3 months after inclusion

• Ischemic event

  6 months after inclusion

• Bleeding event

  3 months after inclusion

• Bleeding event

  6 months after inclusion

Study Arms (2)

experimental

Patients with AF, hospitalized in one of the 6 geriatrics units participating in the study, aged 75 years or over, without evaluation of their antithrombotic treatment by the multidisciplinary team. The lack of review of patient's file by the multidisciplinary team is based on physician decision.

Other: Standard of care, with intervention of the multidisciplinary team

Standard of care

Interventions

Standard of care, with intervention of the multidisciplinary team OTHER

Patients with AF, aged of 75 years or more, with evaluation of their antithrombotic treatment by the multidisciplinary team. The review of patient's file by the multidisciplinary team is based on physician decision. These patients are hospitalized in one of the 6 geriatrics units participating in the study and / or are hospitalized in another ward but their clinical file is reviewed by the multidisciplinary team.

experimental

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients hospitalized in 6 geriatrics units in the Greater Paris area and / or whose clinical file is reviewed by the multidisciplinary team PAtiet

You may qualify if:

• years old patients or more
• Diagnosis of AF
• Hospitalized in one of the 6 geriatrics unit participating in the study and / or whose clinical file is reviewed by the multidisciplinary team

You may not qualify if:

• opposition to data collection for research purposes

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

Unité de gériatrie aiguë, hôpital Pitié-Salpêtrière (Pr Marc Verny)

Paris, 75013, France

Location

Related Publications (1)

• Prunel M, Cochard A, Abbas L, Baudry E, Pautas E, Legris N, Assayag P, Frere C, Verny M, Simon-Tillaux N, Zerah L. Multidisciplinary team for antithrombotics management and clinical outcomes in older adults with atrial fibrillation: a target trial emulation. BMC Med. 2025 Sep 29;23(1):521. doi: 10.1186/s12916-025-04291-9.

  PMID: 41024059 DERIVED

MeSH Terms

Conditions

Atrial Fibrillation

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Arrhythmias, Cardiac; Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 14, 2021
• First Posted: June 21, 2021
• Study Start: May 29, 2021
• Primary Completion: July 5, 2024
• Study Completion: July 5, 2024
• Last Updated: July 2, 2025

Record last verified: 2025-07

Locations

FR (1)