Atrial ablation and not anticoagulated search folder
The Atrial ablation and not anticoagulated search folder is part of 012. Audit ready
The Atrial ablation and not anticoagulated folder contains a search and report which can be used for monitoring and audit purposes.
The search RWA-131) Patients who have had atrial ablation but are not anticoagulated identifies patients with a code for an ablation but have not received an issue of an oral anticoagulant in the past 3 months.
The oral anticoagulants included are: Warfarin; Apixaban; Dabigatran; Edoxaban; Rivaroxaban.
Long-term anticoagulation post ablation should be continued (based on pre-treatment CHA2DS2-VASc score) even in those in sinus rhythm.
The search has been designed with audit in mind so it only looks for codes added up until 'today', as well as medication issues from 3 months ago up until 'today'. This allows users to use a relative run date in the past and obtain data from a different 3 month period without pulling data which had not yet been added had the search been run on the intended date (ie: setting a relative run date of 01/04/2022 will look at the range 01/01/2022 - 31/03/2022, but no data added after 01/04/2022).
Users should look at the report to review identified patients. The report will show the date of any 'first' or 'new' codes (to keep the report concise), as well as the most recent oral anticoagulant issues if one exists. Where a code denoting anticoagulation not indicated/tolerated/wanted or contraindicated exists, the most recent is shown. The pre-ablation CHADS2 or CHA2DS2-VASc score is not shown, so this should be confirmed from the patient record (if coded).
The report can be used to identify gaps in coding contraindications as well as following up on patients whose medication ordering has lapsed. There may be an opportunity to discuss why the medication was stopped if there is no obvious reason written on the patient record.
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