Important notice:
From 15th May 2012, the team delivering the work of the NPC will form the NICE Medicines and Prescribing Centre and will sit alongside the Clinical Guidelines team within the Centre for Clinical Practice.
As part of NICE, all future Medicines and prescribing outputs will be published on the NICE website and signposted from the Medicines and prescribing home page.
Atrial Fibrillation - Patient decision aids
Changes/additions to materials: (21/03/11)
EMA recommends restricting the use of dronedarone▼
Following a review of its benefit-risk balance, the European Medicines Agency (EMA) has recommended that dronedarone▼ should only be prescribed for the maintenance of heart rhythm in patients with paroxysmal or persistent atrial fibrillation (AF) and whose normal rhythm has been restored. It should not be used in patients with permanent AF, heart failure or left ventricular systolic dysfunction. Dronedarone should be prescribed only after alternative treatment options have been considered, because of an increased risk of liver, lung and cardiovascular adverse events. Please see MeReC Rapid Review No. 4451 for more details.
NICE issues FAD on dabigatran for atrial fibrillation
After considering the feedback from consultation, the NICE Appraisal Committee has prepared a Final Appraisal Determination (FAD) on dabigatran for the prevention of stroke and systemic embolism in atrial fibrillation. Subject to any appeal by consultees, the FAD may be used as the basis for NICE guidance, which is due to be published in December 2011.
NICE guidance on clopidogrel and MR dipyridamole updated
Since these materials were published, NICE has updated technology appraisal guidance 90 on clopidogrel and modified release (MR) dipyridamole for the prevention of occlusive vascular events. The changes made in technology appraisal guidance 210 have been summarised in MeReC Rapid Review No. 2353.
Generic clopidogrel is now recommended by NICE ahead of combination use of aspirin plus MR dipyridamole in people who have had an ischaemic stroke. It is also now recommended as the first choice option for patients with peripheral arterial disease or multivascular disease. Clopidogrel is not recommended for use after a transient ischaemic attack (TIA): aspirin plus modified release dipyridamole remains first choice treatment after a TIA. There is now no recommended maximum duration for any of these treatments
Aspirin is still recommended by NICE as first choice after a myocardial infarction. Clopidogrel should be used only if aspirin is contraindicated or not tolerated.
The patient decision aids have been developed to help guide difficult decisions in which patients need to consider benefits versus risks. Decision aids prepare patients for decision making by increasing their knowledge about expected outcomes and personal values.
These documents are based on the best available evidence but are not a substitute for a discussion with a suitably skilled healthcare professional. We hope that their use in such discussions will result in better informed, patient-focused decision making.
You can either view the decision aid on the screen or you can download and print a copy by clicking the 'PDF'.
Download a copy of the atrial fibrillation patient decision aid
If you are interested in finding out more about how to make the best use out of patient decision aids, please see our e-learning resources on shared decision-making with patients
Let us know what you think about our PDAs and how you use them
We are always grateful for feedback, indeed without it most of this work would not have been possible. For feedback and enquiries, please email nice@nice.org.uk
