Expert support for the innovative project
The grant winner will receive 500,000 rubles as a lump sum for the development of the project.
According to the Russian Cardiology Society, an expert jury analyzed 84 applications from 34 regions of Russia and 58 healthcare facilities. According to the rules of the grant, any cardiologist who will provide a project for the implementation of innovative approaches to improve the treatment efficacy of patients with atrial fibrillation could become a participant. When evaluating the projects, the following issues were considered: scientific novelty, interdisciplinary approach, treatment compliance increase in patients with atrial fibrillations, the possibility to introduce the suggested method into actual clinical practice and the common social and economic significance of the project.
Elena Gorbunova presented for a grant a decision-taking module “Personalized choice of anticoagulant in patients with atrial fibrillation at the outpatient stage”. Her scientific research is corroborated by experience.
“In cardiological practice, there is a problem of management of patients with atrial fibrillations, the most common among which is arrhythmia. A cardiologist has to take a decision on the choice of the therapy, in this case an anticoagulant, and it is time-consuming which is impossible in large workload in the clinic,” says Elena Gorbunova, M.D., PhD, leading research associate of the Laboratory of Cardiac Rhythm Disorders and Cardiac Pacing of the NII KPSSZ, Head of the Cardiology Polyclinic of Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash. “A specially designed program is proposed to facilitate a doctor’s work in making the right decision and to make the most efficient prescription to a patient. It is based on the algorithm of personalized choice of an anticoagulant taking into account the clinical and demographic data of the patient, his or her medical history and reversible risk factors for bleedings.” The choice of the optimum medication will take into account the main diagnosis, creatinine clearance – an indicator of the renal blood flow velocity evaluation, the renal comorbidity, diabetes mellitus and patients’ preferences for a single-dose anticoagulant intake. An electronic outpatient medical record of a patient with atrial fibrillation will be improved, which will be able to be used not only in primary outpatient-polyclinic facilities, but also at the inpatient treatment stage in specialized cardiology and cardiac surgery clinics and in multidisciplinary medical centers. It can be expected that the implementation of our project in the Kemerovo region will result in reducing the number of myocardial infarctions, strokes and other thrombotic complications, because the patients will be prescribed with efficient and safe anticoagulant therapy.
A decision-taking module will be used in formation of a unified registry of patients with atrial fibrillation to improve the quality and the prognosis of their life. The unified outpatient cardiology service of Kemerovo with the assistance of cardiologists from the other territories of the region will allow in a short time to create a register of patients with atrial fibrillation which will include more than 2000 patients within a short time. An anticoagulant center, which has been opened since 2014 on the basis of the polyclinic of the Regional Cardiology Dispensary, will be playing a coordinating role. Recommendations on primary and secondary prevention of acute thrombotic events in minimizing the hemorrhagic complications will be given. The patients with poor compliance will be recommended to study in the “School of patients taking anticoagulants” which has been opened in the center since 2010.
As the jury noted, the research of Elena Gorbunova has a novel view on the problems in prescribing the anticoagulant therapy. The scientific importance is in advancing the existing knowledge system in the peculiarities of oral anticoagulants prescription taking into account the current recommendations and standards for management of patients with atrial fibrillation.