Increased use of direct oral anticoagulants (DOACs) prevented an estimated 17,000 strokes and 4,000 deaths in the last 18 months in England
The National Health Service (NHS) has said that the roll-out of blood-thinning drugs has helped save thousands of lives.
In January 2022, the NHS launched a drive to rapidly expand the use of life-saving direct oral anticoagulants (DOACs) in people who are at increased risk of strokes.
Since then, more than 24 million prescriptions have been given to such patients and around 460,000 more people have started taking the drugs.
This prevented an estimated 17,000 strokes and 4,000 deaths in the last 18 months, as revealed by the new NHS data.
Amanda Pritchard, the NHS chief executive, hailed the “lifesaving NHS rollout” at the King’s Fund annual conference.
It is part of a major NHS drive on "prevention" - to catch more killer conditions earlier and save more lives.
Pritchard said: “It’s outstanding news that these drugs have potentially helped save thousands of lives already and prevented many more people from suffering the serious and often debilitating effects of strokes.”
“Thanks to hardworking NHS teams across the country, the rapid roll-out of these drugs is a monumental step forward in providing the best possible care for patients with cardiovascular conditions,” she added.
Dr Maeva May, Associate Director for Policy and Research at the Stroke Association, is feeling “fantastic” on hearing the good news that “oral anticoagulants have helped to prevent so many strokes over the last two years.”
How do anticoagulants help save lives?
According to NHS England, the drugs stop strokes by “treating and preventing blood clots” in patients with atrial fibrillation (AF), a condition that can cause an irregular and often abnormally fast heart rate.
It is estimated that around 1.5 million people in England are living with AF, which causes one in five strokes.
Unfortunately, patients with atrial fibrillation may not experience any symptoms until a stroke.
Dr May said: “AF accounts for one in five strokes and strokes in people with AF are more severe and are more likely to result in death or serious disability.
“The good news is that if AF is identified it can be managed. The majority of AF-related strokes are preventable with the right medication. Managing AF correctly improves people’s quality of life and is cost-effective for the system. Both AF and other stroke prevention measures must continue to be prioritised regionally and nationally.”
A guideline by the National Institute for Health and Care Excellence (NICE) has recommended four DOACs as clinical and cost-effective treatments.
However, among the four DOACs, the NHS commissioning guidance in January 2022 recommended the use of edoxaban as a preferred option for prescribers.
Following their accelerated roll-out of the drugs, 90 per cent of patients with AF and those at high risk of stroke are now receiving treatment, the NHS said.
As the most cost-effective option, this drug is helping the NHS save more than £100 million in medicine costs.
The programme is also helping the NHS meet a national public health target six years early.
In 2019, the National Cardiovascular Disease Prevention System Leadership Forum, which comprises 40 organisations including NHS England, set the target of treating 90 per cent of patients with AF with DOACs by 2029.
This milestone was reached within 18 months after the NHS issued the guidance advising clinicians to prescribe DOACs for people with the condition.
Innovative schemes to diagnose and treat AF patients
Additionally, £45 million has been invested in ‘Detect, Protect, Perfect’ initiatives, which allow local NHS teams to launch innovative schemes to diagnose and treat patients with AF.
This investment is a part of groundbreaking agreements between NHS England and pharmaceutical industry partners.
This initiative has been launched at 12 GP practice sites in Leicestershire, where the patients are provided with devices to opportunistically test for AF while they sit in the waiting room.
Patients found to have the condition via the handheld device are referred for follow-up testing and treatment within 24 hours.
Lead Clinical Pharmacist, Niraj Lakhani, who has helped roll out the scheme, said: “With high prevalence rates of atrial fibrillation in Leicester, it’s vital we continue to do all we can to detect and prevent strokes and the devasting impact they can have for patients and their loved ones.
“This initiative not only helps detect AF without impacting on any consultation time but also has the potential to save the health system significant amounts of money by preventing costly strokes.”
