Ethnic Differences in Patient Perceptions of Atrial Fibrillation and Anticoagulation Therapy: The West Birmingham Atrial Fibrillation Project
Abstract
BACKGROUND AND PURPOSE: We hypothesized that different ethnic groups would have different levels of knowledge and perceptions of atrial fibrillation (AF) and of their antithrombotic therapy. To investigate this further, we conducted a cross-sectional survey of patients with documented chronic AF who were attending the anticoagulation clinic in our city center teaching hospital, serving a multiethnic population. METHODS: We surveyed 119 patients (77 male; mean age 69+/-9 years [mean+/-SD]); of these, 39 were Indo-Asian (33%), 27 Afro-Caribbean (23%), and 53 white (44%). RESULTS: Only 63% of patients in the overall study cohort were aware of their cardiac condition, with Indo-Asians and Afro-Caribbeans significantly less aware of AF compared with the white patients (P<0.001). When questioned about the perception of the severity of the underlying condition, the majority (61%) felt that AF was "not serious." A large proportion were unaware that AF predisposed to thrombosis and stroke; among the ethnic groups, Indo-Asians appeared to be the least aware of the stroke and thromboembolic associations of AF. Only 52% in the whole cohort were aware of the reason(s) for commencing their warfarin, whereas the remainder began warfarin therapy simply because their "doctor told them to." Most patients in the whole cohort were aware of warfarin being used to prevent blood clots (65%) or stroke (66%), but Indo-Asians and Afro-Caribbeans were less so. Only 45% of the study cohort believed that there was some risk associated with warfarin therapy in the form of either "bleeding" or "poisoning." Only a minority of Indo-Asians and Afro-Caribbeans with AF felt that their doctor had given them enough information about their warfarin therapy, and many from these ethnic groups felt that they were careless about taking their warfarin. CONCLUSIONS: In conclusion, many patients with AF possess very limited knowledge of AF as well as its consequences and therapy. In particular, our study has highlighted significant differences between different ethnic groups in terms of their knowledge of the risks, actions, and benefits of warfarin as well as of AF itself.
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Lack of AF-related knowledge in patients is common, even in those who have received verbal and written information.
“However, lack of AFrelated knowledge in patients is common, even in those who have received verbal and written information, 32,1011,1012”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [1012]
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Self-citation
- Authors
- Lip, G. Y. H., Kamath, S., Jafri, M., Mohammed, A., & Bareford, D.
- Affiliations
- Birmingham City Hospital (GB)
- Venue
- Stroke
- Published
- 2002-01
- Volume
- 33
- Issue
- 1
- Pages
- 238-242
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W1708053152
- Cited by
- 168
- References
- 21
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 9 · 2019: 7 · 2018: 9 · 2017: 8 · 2016: 12 · 2015: 11 · 2014: 10 · 2013: 10 · 2012: 4
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Sanofi
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, anticoagulation, warfarin, ethnic differences, patient knowledge, patient perspectives, thromboembolism, Afro-Caribbean patients, patient education, medication adherence, bleeding risk
- MeSH terms
- Aged, Anticoagulants, Atrial Fibrillation, Cross-Sectional Studies, England, Female, Humans, Male, Patients, Perception, Warfarin, Cohort Studies
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