[Structured switching from warfarin to DOAC in patients with atrial fibrillation]

In patients with atrial fibrillation (AF) at risk of stroke, direct oral anticoagulants (DOAC) have been shown to be at least as effective as warfarin, offering advantages like reduced monitoring requirements and lower bleeding risks. Disadvantages include limited data in patients with severe chronic kidney disease and higher patient costs. In mid-2021, Region Örebro County, Sweden, decided to switch suitable patients with AF from warfarin to DOAC. Out of the 823 patients receiving warfarin therapy, 732 were identified as suitable candidates for DOAC, and 89 percent of these patients were successfully switched. Switching from warfarin to DOAC offers superiority and simplifies treatment and monitoring. However, individual needs and risk factors must be carefully considered before switching. As many patients in Sweden continue to be prescribed warfarin, this initiative could potentially model for other regions.