The future of anticoagulation management in atrial fibrillation in Europe: An assessment of today's challenges with recommendations for the future: Annexes

RAND Europe is a not-for-profit research institute whose mission is to help improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit 1 The study employed a multi-method approach to explore the current and future management of atrial fibrillation (AF) in Europe, with a focus on anticoagulation (Figure A.1). It involved a rapid evidence assessment of the literature , interviews with experts and the use of future scenarios as a tool for refining our understanding of future developments. All of these activities were carried out with feedback and input from a steering committee made up of 10 experts in cardiology and related areas from across six European focus countries. Findings from the desk-based tasks (the literature assessment and expert interviews) were analysed with a focus on political , economic, social, technological, legal and environmental (PESTLE) factors, in addition to population trends. This analysis was used to develop scenarios that were further refined and developed in a workshop with the steering committee. The workshop also involved discussion of risks and opportunities associated with the scenarios under consideration, and this discussion served as the basis for developing recommendations. In the following sections we outline in more detail the methods used for each of these activities. The rapid evidence assessment (REA) of the current literature had the following objectives: 1. To explore current AF management techniques across the six focus countries, both in terms of official guidance and how this guidance is employed in practice. 2. To assess ageing population trends and how they are likely to impact on the prevalence of AF and management options. APPROACH METHODS Collate existing knowledge Design of potential futures Analysis of discussion around potential futures Reporting Rapid evidence assessment Key informant interviews Scenarios Engagement with steering committee 2 The future of anticoagulation management in atrial fibrillation in Europe supplemented with additional …