AEGEAN trial results: Does patient education actually matter?

An educational programme to encourage adherence to the new anticoagulant apixaban (Eliquis, Bristol Myers-Squibb), in the first 6 months of treatment in AF patients made no difference to compliance rates in the Assessment of an Education and Guidance Programme for Eliquis Adherence in Non-Valvular Atrial Fibrillation (AEGEAN) study

Education included a patient information booklet explaining AF and anticoagulant treatment for stroke prevention, reminder tools (key ring, mobile phone alerts), and access to a virtual clinic with staff from existing anticoagulation clinics. Adherence was measured using an electronic device that holds a blister pack of medication and records each time the pack is removed. At 24 weeks, the adherence rate was 88.5% in the control group and 88.3% in the education group (P=0.89), and persistence rates were 90.5% and 91.1% respectively (P=0.76).

Whether these figures persist longer than 24 weeks remains to be seen. Long term adherence to a medication regimen may be more difficult to achieve without professional support.


CLOT To Present a Session at 2016 British Society of Haematology Meeting



We are pleased to report that CLOT have been asked by the British Society of Haematology to present a session during next year’s meeting in Glasgow. This is an exciting opportunity as we will be the only nursing and allied profession organisation who will be presenting. Our provisional programme there includes sessions on whole leg vs upper leg ultrasound scanning, how long to anticoagulate for post VTE diagnosis and community v hospital acquired thrombosis. The website for the event is as below and more details to follow once the programme is confirmed.

SOME trial casts doubt on enhanced cancer screening in VTE patients

The link between VTE and cancer is well known. However, the need for extensive screening f or occult cancer in patients who have an unprovoked VTE remains unclear.  The SOME trial, published in the New England Journal (22/06/15), compared standard screening ( complete history taking and physical examination, measurement of complete blood counts and serum electrolyte and creatinine levels, liver-function testing, and chest radiography  and sex-specific examinations) with enhanced screening which included a CT scan. The rates of occult cancer detection in the study proved to be surprisingly low, and the benefits of the additional CT scan were limited. The authors concluded that: “ In our trial, a screening strategy for occult cancer that included comprehensive CT of the abdomen and pelvis did not lead to fewer missed cancers than the number missed with a limited screening strategy. Furthermore, the screening strategy that included CT did not appear to detect significantly more occult cancers (including early cancers), shorten the time to cancer diagnosis, or reduce cancer-related mortality.”

Reversal agent for Dabigatran moves a step closer

The New England Journal of Medicine (22/06/15)  has published the results of the Reversal Effects of Idarucizumab on Active Dabigatran (REVERSE-AD) trial. The results indicate that a complete reversal of the anticoagulant effects of Dabigatran in 88-98% of the 90 patients studied was achieved.  The trial included patients who had life-threatening bleeding whilst on Dabigatran or who required urgent surgery.  It therefore brings the prospect of a fully-reversible DOAC a step closer.