Assessment of Sudanese cardiac health-care professionals' competency and adherence to the current anticoagulation guidelines with non-valvular atrial fibrillation Sudanese patients

Background: Non-valvular atrial fibrillation (NVAF) needs more carefully address, with special caution to the risk of ischemic stroke, which is the most serious complication. The first line of defense against NVAF-related stroke is an anticoagulant. Anticoagulants have been used frequently for years to prevent and treat this potentially deadly blood clot. However, widely used traditional therapies are associated with significant limitations. Objectives: The objective is to study the assessment of Sudanese cardiac health-care professionals’ use of objective risk assessment tools and stroke prophylaxis in NVAF patients. Materials and Methods: Ninety-nine cardiac health-care professionals from different cardiac centers in Khartoum were responded to the assessment survey to evaluate their daily practice and availability of different facilities to improve the quality of work, in which they were asked series of questions if they use AF patient assessment tools for stroke and bleeding. Validated questionnaire had been used for conducting interviews. Results: As far as the competency of cardiac staff members’ results reveals that majority of the staff, i.e., 78.8% did not attend any internal and external educational programs related to antithrombotic therapy and less than half of participants, i.e., 20.2% educated about new drugs added to the Sudanese national formulary and associated protocols/guidelines. 75% of participants answered that there is no trained, multidisciplinary antithrombotic team available 24 h each day and 7 days each week and 24% answered that team is available. 85% of patients were assessed for stroke based on clinical judgment while 3% of patients were stratified for stroke risk using the CHA2 DS2 -VASc stroke risk stratification scheme, and also, in the great majority of the NVAF patients, i.e., 96%, bleeding risk was assessed using clinical judgment. Conclusions: Findings indicate that physicians and other staff members do not adhere well to the current anticoagulation guidelines and they need to be more updated about the new antithrombotic therapy through regular and continuous education. This study demonstrates that many moderate-risk patients are receiving oral anticoagulation similar to many high-risk patients receiving oral anticoagulation. Therefore, approximately two-thirds of Sudanese patients both men and women were receiving oral anticoagulation and only one-third of them were truly at high risk and need antithrombotic therapy.