P374 MANAGEMENT OF A HOSPITAL NURSING OFFICE FOR AF AND CONTROL OF DIRECT ORAL ANTICOAGULANT THERAPY IN THE COVID EMERGENCY PHASE

• Published in: European heart journal supplements Vol. 24; no. Supplement_C
• Main Authors: Pagliani, L, Colledan, C, Bertoldo, I, Magoga, J, Modolo, M, Visintin, E, Nicolosi, E, Di Naro, A, Denas, G, Antonini–canterin, F
• Format: Journal Article
• Language: English
• Published: 18.05.2022
• ISSN: 1520-765X; 1554-2815
• DOI: 10.1093/eurheartj/suac012.360

Abstract Anticoagulant therapy is the gold standard treatment in thromboembolic prevention in AF patients. Starting from the indications from the regional indications that give the therapeutic diagnostic path, a divisional clinic dedicated to the diagnosis and treatment of AF was born in our territory. The aim of the team (Cardiologists, Nurses, GPs, administrative secretariat) was to monitor the number of patients treated with DOACs through AIFA therapeutic plans; Verify adherence to regional guidelines, analysis of therapy adherence; Prepare a protocol for the management of complications and emergencies; Ensure that the departments and services authorized to prescribe NOA take charge, in collaboration with general practitioners who since June 2020 have become active prescribers and also actors in the follow–up of patients; Taking care of the training of the prescribers themselves and the education of patients through hospital meetings dedicated to guided counseling and, finally, monitoring the pharmaceutical expenditure of the NOA on the total prescription of the local health unit of competence in compliance with the regional indicators. In our hospital the pilot project started in 2017 (3726 currently in FU). In the three–year period 2017–19, an average of 700 therapeutic plans were collected for renewal / first prescription per year (58.3 plans / month) to be monitored in subsequent years. In the two–year period 2020–2021, which saw the difficulty of organizing activities due to the pandemic emergency, 903 and 790 PTs were analyzed with an average of 70 plans / month, keeping almost 75% of face to face visits compared to telemedicals set up in the pandemic context. According to the data, therefore, there is a strong need for diagnostic and health assistance paths. Despite the emergency period and despite a framework in which territorial medicine could have helped the clinical and bureaucratic effort, no resistance to the care burden has occurred and on the contrary the constant increase in patients makes the complexity and difficulty of a correct clinical classification and management support for patients with AOC needs