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By John Smith, Innovation Agency Added 26th Oct, 2016 Updated 23rd Jul, 2019



‘Don’t Wait to Anticoagulate’ (DWAC), an initiative led by the West of England AHSN and part of a joint working agreement with industry, supports primary care to reduce the burden of Atrial Fibrillation (AF)-related stroke.

A joint working project with Bayer HealthCare since September 2014, DWAC aims to:

  • Increase rates of appropriate anticoagulation use in patients with high risk of AF-related stroke
  • Reduce the number of high-risk patients receiving no treatment and/or anti-platelet therapy
  • Optimise anticoagulation of AF patients unstable on Warfarin through transfer to Direct Oral Anticoagulants in accordance with NICE Guidance (CG180)
  • Develop a quality improvement approach enabling clinicians to re-evaluate identification, diagnosis and treatment and consider NOACs alongside traditional anticoagulants
  • Develop a strategic, sustainable approach enabling CCGs to drive implementation
  • Increase the number of GP practices with the knowledge of quality improvement approaches
  • Increase clinician confidence in prescribing and managing all OACs

More than seven strokes have been avoided due to DWAC in Gloucester CCG.

DWAC principles are being used in the North West Coast with four CCGs signed up to the AF Collaborative, a  partnership between the Pharma industry, CCGs and the Innovation Agency.



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