Article Text

Download PDFPDF
Application of the UK NHS Improvement Anticoagulation Commissioning Support Document for ‘safety indicators’ in atrial fibrillation. Results of the European Action on Anticoagulation study
  1. Leon Poller1,
  2. Jørgen Jespersen2,
  3. Campbell Cowan3,
  4. Trevor Baglin4,
  5. Jennifer George5,
  6. Saied A Ibrahim6
  1. 1European Action on Anticoagulation (EAA) Central Facility, Faculty of Life Sciences, University of Manchester, Manchester, UK
  2. 2Department of Clinical Biochemistry, Hospital of South West Denmark, Esbjerg and Department for Thrombosis Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark
  3. 3Cardiology Department, Leeds General Infirmary, Leeds, UK
  4. 4Department of Haematology, Addenbrooke's NHS Trust, Cambridge, UK
  5. 5NHS Improvement, Leicester, UK
  6. 6Research Statistician, EAA Central Facility, Faculty of Life Sciences, University of Manchester, Manchester, UK
  1. Correspondence to Professor Leon Poller, EAA Central Facility, The University of Manchester, Faculty of Life Sciences, Manchester M13 9PT, UK; ecaa{at}


Introduction 'Safety indicators' in the anticoagulant management of atrial fibrillation (AF) are listed in the UK NHS Improvement Document, ‘Anticoagulation for AF’, aiming to promote quality services. Acceptable clinical event rates are not quantified in the document.

Objective To provide clinical evaluation of the relevant safety indicators using data from a recent large European Action on Anticoagulation (EAA) study.

Results 469 clinical events were recorded in 5839 outpatients in the EAA study. The safety indicators listed in the NHS Improvement Document were related to these patients with AF. The relevance of the ‘safety indicators’ is confirmed by the EAA study for patients starting oral anticoagulation and for those already receiving oral anticoagulation, and quantified.

Conclusion The EAA clinical study provides a quantitative basis for the safety indicators' in AF listed in the NHS Commissioning Support Document and emphasises the importance of the document.

  • Anticoagulants
  • haematology
  • computer assisted
  • quality assurance
  • safety
  • haematology
  • heart
  • medical education

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • EAA International Sensitivity Index Calibration Studies. AMHP van den Besselaar, Leiden University Medical Centre, Leiden. EAA External Quality Assessment Studies. A Tripodi, University and IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milan, Italy.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.