Optimise programmes

Atrial fibrillation (AF): Focus on direct-acting oral anticoagulants (DOACs)

Aim

The purpose of this programme is to increase your knowledge, skills and confidence in supporting people living with atrial fibrillation to reduce their stroke risk through optimisation of direct-acting oral anticoagulants, taking a shared decision-making approach.

Background learning

The Atrial fibrillation (AF): Focus on direct-acting oral anticoagulants (DOACs) Optimise programme assumes some prior knowledge of the topic. If you wish to revise your knowledge, you may find the CPPE Fundamentals of cardiovascular therapeutics e-course Unit 2: Atrial fibrillation helpful as an optional learning resource. This e-course unit takes around two to three hours.

Small group learning

This workshop involves 20 minutes of preparation for each participant and a 40-minute group session. During the small group learning session, activities will allow learners to test their knowledge, debate controversial topics, make justified clinical decisions and practice communicating with patients and/or other healthcare professionals.

Learner resources

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Facilitator's resources

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Next steps

After the workshop, consider your next steps:

Review the suggested answers, your facilitator will provide these to you.
Complete the feedback survey.
Reflect on what you have learnt and how you can put it into practice within your role. You may also find it useful to arrange a peer discussion.
Create an action plan including specific, measurable, achievable, realistic and timebound (SMART) details.
Consider any other learning resources which may support your next steps, including:

View acknowledgments, references and brand names

Expert and programme contributors
Romesh Rana, senior prescribing adviser, NHS Birmingham and Solihull ICB and Pharmacist Independent Prescriber (CVD), Springfield Medical Practice
Paul Wright, consultant cardiovascular pharmacist, Barts Health NHS Trust

CPPE programme developer
Emma Barnes, regional manager

Content contributors
Aanchal Bahl, senior specialist pharmacist cardiology, London North West University Healthcare NHS Trust
Elisabeth Brooke, PCN lead pharmacist, Wyre Forest Network of Independent Practices
Ellen Carberry, education supervisor, CPPE
Sahar Mesgarpour, acute and emergency medicine, King’s College Hospital NHS Foundation Trust
Siobhan Powney, lead pharmacy technician, medicines management, South Warwickshire University NHS Foundation Trust
Romesh Rana, senior prescribing adviser, NHS Birmingham and Solihull ICB and Pharmacist Independent Prescriber (CVD), Springfield Medical Practice
Debs Teale, person with lived experience
Jennifer Vose, pharmacy technician, North Arden PCN
Benjamin Waters, lead cardiac pharmacist, Barts Health NHS Trust
Paul Wright, consultant cardiovascular pharmacist, Barts Health NHS Trust

Reviewer(s)
Romesh Rana, senior prescribing adviser, NHS Birmingham and Solihull ICB and pharmacist independent prescriber (CVD), Springfield Medical Practice
Paul Wright, consultant cardiovascular pharmacist, Barts Health NHS Trust

CPPE reviewer(s)
Elizabeth Allsup, lead learning development pharmacist
Sarah Ridgway-Green, regional manager
Karen Walker, education supervisor

Piloted by
Nicola Lewis, lead pharmacist for education and training, South Warwickshire University NHS Foundation Trust
Sarah Baig, pharmacy professional lead, Black Country Training Hub, Black Country Integrated Care Board

CPPE editor
Lee Swettenham, deputy editor and research editor

References

British Heart Foundation. England Cardiovascular Disease Factsheet. September 2025. https://www.bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-england-factsheet-sep25.pdf
National Institute for Health and Care Excellence. Guideline [NG196]. Atrial fibrillation: diagnosis and management. 1.6 Stroke prevention. Updated June 2021. https://www.nice.org.uk/guidance/ng196/chapter/Recommendations#stroke-prevention
National Institute for Health and Care Excellence. Quality standard [QS93]. Atrial fibrillation. Updated February 2018. https://www.nice.org.uk/guidance/qs93/chapter/Quality-statement-3-Discussing-options-for-anticoagulation
NHS England. NHS prevents thousands of strokes, thanks to lifesaving drive. December 2024. https://www.england.nhs.uk/2024/12/nhs-prevents-thousands-of-strokes-thanks-to-lifesaving-drive/
National Institute for Health and Care Excellence. Guideline [NG196]. Atrial fibrillation: diagnosis and management. 1.1 Detection and diagnosis. Updated June 2021. https://www.nice.org.uk/guidance/ng196/chapter/Recommendations#detection-and-diagnosis
Specialist Pharmacy Service. DOACs (Direct Oral Anticoagulants) monitoring. Updated September 2025. https://www.sps.nhs.uk/monitorings/doacs-direct-oral-anticoagulants-monitoring/

Disclaimer
We have developed this learning programme to support your practice in this topic area. We recommend that you use it in combination with other established reference sources. If you are using it significantly after the date of initial publication, then you should refer to current published evidence. CPPE does not accept responsibility for any errors or omissions.

External websites
CPPE is not responsible for the content of any non-CPPE websites mentioned in this programme or for the accuracy of any information to be found there.

All web links were accessed on 16 September 2025.

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