ABOUT THE SURVEY
The Heart Rhythm Society (HRS) and National Stroke Association, in collaboration with
Boehringer Ingelheim (BI), fielded the Impact of Stroke Survey in May of 2014 to physicians,
atrial fibrillation (AFib) patients and caregivers. The purpose of the survey was to measure
awareness about AFib and stroke, determine baseline understanding of risk factors, and identify
barriers to communication between patients/caregivers and providers. More than 1,200
respondents participated in the survey including 507 physicians, 499 AFib patients, and 203
caregivers of stroke survivors with AFib.
SURVEY FINDINGS
Impact of Stroke
The impact of AFib-related stroke on patients and caregivers can be devastating. The
majority of stroke survivors surveyed say that experiencing a stroke was worse than they
could have imagined, and many survivors and caregivers have had to give up jobs,
activities or hobbies that brought them joy.
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How does life change for people that survived a stroke?
Experiencing a stroke affects someone’s life in numerous ways. More than three in four
stroke survivors surveyed (77 percent) agree that their life has not been the same since
experiencing an AFib-related stroke. Of those surveyed:
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Among survivors who indicated their lives have not been the same, more than one-half
(56 percent) indicate they can no longer do activities or hobbies that bring them joy.
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Among survivors who indicated their lives have not been the same, two in five (40
percent) indicate it has been a financial burden; nearly half (44 percent) indicate they
had to give up their job or reduce their hours.
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Nearly three in four stroke survivors (73 percent) agree that experiencing a stroke
was worse than they had imagined.
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88 percent of stroke survivors living with AFib experienced difficulty or limitations
within the first six months following their stroke. Of those, 81 percent experienced
motor limitations.
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Three in five stroke survivors (60 percent) sometimes feel like they are a burden to
others since experiencing an AFib-related stroke.
How does life change for caregivers of stroke survivors with AFib?
The burden on caregivers of AFib stroke survivors can be life altering. In fact, 91 percent
of caregivers surveyed agree that their lives have not been the same since the person in
their care experienced an AFib-related stroke. Of those surveyed:
 68 percent noted their relationship with the stroke survivor is different than it used to be.
 Two in three caregivers (66 percent) don’t have as much time to do the activities or
hobbies that bring them joy.
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Three in five caregivers (60 percent) feel like they have more to do than they can
handle.
More than half of caregivers (56 percent) feel socially isolated.
Six in seven caregivers (86 percent) couldn’t have imagined the amount of work it
takes to care for a stroke survivor.
75 percent of caregivers noted that the stroke survivors in their care can no longer
drive and that they need assistance with daily activities.
Patient-Physician Communication About Stroke Risk Reduction
The results of this new survey reveal a perception gap between physicians and patients
when having conversations about AFib and the increased risk of AFib-related stroke.
While the majority of surveyed physicians and patients do talk about risk, they disagree
about who initiates the conversations. Further, surveyed physicians believe there are
significant challenges to educating patients.
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Are AFib patients discussing their risk of stroke with their physician?
Yes, 64 percent of AFib patients surveyed recall discussing an increased risk of stroke due
to AFib with their physician at the time of diagnosis. However, that means more than onethird of patients may not have had this initial conversation.
What did the research reveal regarding conversations between physicians and
patients?
The research revealed a perception gap between physicians and patients when having
conversations about AFib and the increased risk of AFib-related stroke. Surveyed
physicians indicate that they initiate nine in every ten (90 percent) conversations about
increased risk of AFib related stroke, yet patients indicate they initiate nearly half (47
percent) of the conversations. On average, caregivers indicated that more than three in
four (78 percent) conversations about treatments to reduce the risk of AFib related stroke
are initiated by the physician.
Are there any barriers for physicians when educating their patients about AFibrelated stroke?
Physicians believe there are significant challenges to educating patients. When asked
about common barriers to patient education, surveyed physicians cite the following as the
top three barriers that they perceive:
 Patients feel risk of AFib-related stroke goes away once symptoms are being treated.
 Patients think risks outweigh the benefits for medications reducing the risk of AFibrelated stroke.
 Patients have trouble understanding what is being explained.
Treatment Compliance
Surveyed patients and physicians report differing perceptions of compliance when
therapy is initiated to reduce the risk of stroke. Physicians often perceive barriers to
prescribing therapy and believe too many patients underestimate the importance of
therapy adherence, while the majority of patients say that they will do whatever their
physicians tell them to reduce the risk of stroke.
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What are the largest patient compliance barriers according to physicians?
Compliance barriers vary among the different physician groups surveyed. For example,
risk of bleeding is the largest patient compliance barrier according to electrophysiologists
and cardiologists, while monitoring anti-coagulation effect is the most common barrier for
neurologists and general practitioners. Additionally, one-third of cardiologists (33 percent)
and nearly half (48 percent) of electrophysiologists surveyed say patient resistance is one
of the three greatest compliance barriers to therapy initiation.
Are there any barriers or concerns that would prevent patients surveyed from taking
the treatment their doctor prescribed to reduce the risk of stroke?
No, more than nine in ten AFib patients surveyed (93 percent) who have not experienced a
stroke would do whatever their physicians tell them in order to reduce the risk of an AFibrelated stroke. Further, 92 percent of responding AFib patients who have not experienced a
stroke indicated it would not matter to them whether they had to take a treatment once or
twice a day if it reduced the risk of stroke caused by a blood clot in the brain (ischemic
stroke).
Understanding of Stroke Risk Reduction
Surveyed physicians, patients and caregivers agree there is a widespread lack of
awareness about the risks associated with AFib, leading them to call for more
information and educational materials to communicate about AFib and the associated
stroke risk.
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What did the research reveal in regards to physicians’ perceptions of their patients’
understanding of the increased risk of stroke?
The vast majority of physicians surveyed (90 percent) believe AFib patients underestimate
the impact of AFib-related stroke and four in five (79 percent) believe AFib patients are in
denial about their risk of experiencing a stroke.
Do patients understand important facts related to AFib and stroke?
More than two in three (68 percent) AFib patients surveyed were not previously aware that
AFib-related strokes are nearly twice as likely to be fatal or disabling as non-AFib-related
strokes. Of those surveyed:
 One-third (32 percent) of AFib patients do not believe they would be able to describe
the most common symptoms of stroke.
 Only half (54 percent) of caregivers believed AFib caused an increased risk of stroke
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prior to the person in their care experiencing stroke.
Is there a need for more information about AFib and stroke?
Yes, more than four in five physicians surveyed (83 percent) wish they had more
information and educational materials to share with their AFib patients that discuss stroke
risk associated with AFib. Of those surveyed:
 About half (48 percent) of stroke survivors indicate they are doing everything they
can to learn about AFib since experiencing a stroke and 21 percent of caregivers
indicate the person in their care is doing everything to learn about reducing the risk
of stroke due to AFib since being diagnosed.
 Additionally, after the survivor in their care was diagnosed with AFib, four in five
caregivers tried to find out everything they could about it and reducing AFib-related
stroke risk.
Where can people go to learn more about AFib and stroke?
It is important to manage personal risk and know how to recognize and respond to
stroke signs and symptoms. For more information and resources for understanding and
preventing AFib-related stroke, please visit the Heart Rhythm Society at www.myafib.org
or the National Stroke Association at www.stroke.org.
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