Administrative Memos

200203

FROM: Theodore O. Will, Chief Executive Officer
DATE: Apr 08, 2002
SUBJECT: Stroke Prevention in Atrial Fibrillation in Medicaid Patients
IPRO CONTACTS:

Patricia Gagliano, M.D., Clinical Coordinator, x-547
Monte Malach, M.D., F.A.C.C., M.A.C.P., Medical Director/Clinical Coordinator, x-634
Marguerite Shaffer, R.N., C.P.H.Q., Director, Downstate Improvement Strategies, x-634

Enclosed please find a statewide report on Stroke Prevention in Atrial Fibrillation in Medicaid Patients. The purpose of this quality improvement project is to increase utilization of warfarin in eligible Medicaid patients with atrial fibrillation with no contraindications.

IPRO has been working with physicians, providers and other health care personnel since 1994 to improve the use of anticoagulation therapy for eligible patients with atrial fibrillation. Although there has been improvement over the years, 35% of the Medicaid patients who had atrial fibrillation, with no contraindications, were not discharged on warfarin and/or had no documentation of a plan for warfarin.

A statewide random sample of 800 Medicaid cases with a principal or secondary diagnosis of atrial fibrillation patients was selected and the results demonstrated that 65.0% of eligible patients who had no contraindications were discharged on warfarin. This represents an increase from the baseline rate of 62.9%. Although this is a numerical increase, it is not a statistically significant one; possibly due to the small sample size.

Should you have any questions or need assistance with the implementation of a quality improvement program, please feel free to call one of the above-mentioned contacts. Enclosed is a fax order form for stroke prevention materials (including AF), as well as a pocket card with the recommendations based on the Sixth ACCP Consensus Conference on Antithrombotic Therapy for non-valvular AF.