Appendix: Questionnaire
A) General Informations
1. Gender
female
male
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2. Specialization
General practitioner
Internal medicine
Cardiology
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3. Employment
Private practice
Hospital (number of beds Dept. of Internal Medicine)
< 50
50-100
101-200
> 200
4. Professional experience
5-10 years
11-15 years
> 15 years
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B) Guidelines
5. How often to you generally use guidelines for decision making?
Never
sometimes
often
very often
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C) Case Vignette
You are called treat a patient with newly diagnosed atrial fibrillation of more
than 48 hours duration and a CHADS2-Score ≥2 on an outpatient basis. You
decide not to proceed to cardioversion but to controle the heart rate. The
following risk situations are excluded: intracardial thrombi, personal history
with cardioembolic events, mitral stenosis, prosthetic valve, heart failure, left
ventricular ejection fraction <35%, left atrial dilatation of > 50mm, high bleeding
risk or contraindications for an oral anticoagulation.
6. What is your preferred stroke prevention regimen to start with (only single
answer)?
a) You start a low dose oral anticoagulation (OAC) with:
- Marcoumar®
- Sintrom®
b) You start OAC with a loading dose of:
- Marcoumar ®
- Sintrom®
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c) You start OAC with concomitant low molecular weight heparin (LMWH)
subcutaneously:
- prophylactic LMWH dose
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- therapeutic LMWH dose
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d) You prescribe
- Aspirin
- Aspirin + Dipyridamol
- Clopidogrel
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e) You start a combination therapy with OAC + Aspirin or Clopidogrel
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f) others ………………………………………………………………………
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7. If the answer is 6c: When do you stop the LMWH?
a) If the INR is in the target range (2.0-3.0) for two consecutive measurements
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b) If the INR is once in the target range (2.0-3.0)
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c) others:
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8. What was your decision making regarding initial anticoagulation for the above
mentioned Case vignette based on?
- Guideline
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- Clinical experience/Gut feeling
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9. Did you ever observe thromboembolic complications during the initial phase of
anticoagulation in patients with atrial fibrillation?
- No
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- Yes, with: OAC
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LMWH
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OAC + LMWH
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Aspirin/Clopidogrel
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OAC + Aspirin/Clopidogrel
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10. Did you ever observe severe bleeding events during the initial phase of
anticoagulation in patients with atrial fibrillation?
- No
- Yes, with: OAC
LMWH
OAC + LMWH
Aspirin/Clopidogrel
OAC + Aspirin/Clopidogrel
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11. Did you ever observe an anticoagulation induced skin necrosis during the initial
phase of anticoagulation in patients with atrial fibrillation?
- No
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- Yes, with: OAC
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LMWH
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OAC + LMWH
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Aspirin/Clopidogrel
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OAC + Aspirin/Clopidogrel
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D) General questions related to the Case vignette
12. How many Patients similar to the one described in the case vignette did you treat
during the last 6 months?
none
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1 to 5
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>5
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13. How often do you encounter problems when initiating an OAC in outpatients with
atrial fibrillation?
never
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sometimes
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often
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very often
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14. What kind of problems do you come across when initiating an OAC?
Choice of the right drug
patient education regarding OAC
patient instruction regarding LMWH injections
others
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E) Comments
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