AF Survey Final Report AUGUST 2014 Prepared by:. www. russellresearch.com 1 Study Overview The...

AF SurveyFinal Report

AUGUST 2014

Prepared by:

www. russellresearch.com

2

Study Overview

The purpose of this study was to evaluate the impact of Atrial Fibrillation (AFib)-related stroke on patients and caregivers, and to evaluate physician perceptions toward treatment and patient understanding of issues surrounding the condition.

Specific research objectives were to: Understand the impact of AFib-related stroke on patients and caregivers

Measure awareness of facts surrounding AFib and stroke

Uncover the barriers to communication between patients/caregivers and providers related specifically to AFib and stroke

Identify barriers in understanding risk factors

Determine steps taken to learn more about AFib

Evaluate experiences living with AFib and experiencing stroke

To meet those objectives, Russell Research, an independent survey research firm, conducted a telephone and online study among the following populations:

507 Physicians 202 Cardiologists (sample error of +/- 6.9 percent) 101 Electrophysiologists (sample error of +/- 9.8 percent) 53 Neurologists (sample error of +/- 13.5 percent) 151 Primary Care Physicians/Internal Medicine/Family Medicine (referred

to as “General Practitioners” in the report) (sample error of +/- 8.0 percent)

At a 95 percent confidence level, a margin of sample error of +/- 4.4 percent applies to the total physician sample.

499 Atrial Fibrillation patients 248 Atrial Fibrillation-only (sample error of +/- 6.2 percent) 251 Stroke Survivors (sample error of +/- 6.2 percent) At a 95 percent confidence level, a margin of sample error of +/- 4.4

percent applies to the total patient sample.

203 Caregivers of Stroke Survivors with Atrial Fibrillation

At a 95 percent confidence level, a margin of sample error of +/- 6.9 percent applies to the total caregiver sample.

Interviewing for the study was conducted from May 27 – July 3, 2014.

Introduction and Methodology


3

Sample Criteria

In order to qualify for study inclusion, respondents were screened to meet the following criteria:

Physicians

Ages 25 or older Have treated 10 or more AFib-related stroke patients in the past year (25

or more for Neurologists) Spend 70% or more of their time in clinical practice or direct patient care Board certified or board-eligible No pharmaceutical manufacturer employees in household Regularly see Atrial Fibrillation patients (Stroke patients for Neurologists) Average patient age is 18 or older

Atrial Fibrillation Patients

Have been diagnosed with Atrial Fibrillation Stroke Survivors have experienced a stroke in the past

Caregivers

Currently a caregiver for someone who has been diagnosed with Atrial Fibrillation and has experienced a stroke in the past



4

Sample Source & Methodology

Respondents for the study were sourced and interviewed as follows:

Physicians: Online Methodology

Cardiologists: M3 Medical Market Research Electrophysiologists: M3 Medical Market Research & Heart Rhythm

Society 53 Neurologists: M3 Medical Market Research & National Stroke

Association 151 General Practitioners: M3 Medical Market Research


Atrial Fibrillation Patients: Conducted online, sample provided by Survey Sampling International & Research Now

Stroke Survivors: Conducted online and via telephone, sample provided by National Stroke Association, Survey Sampling International & Research Now

Caregivers

Conducted online and via telephone, sample provided by National Stroke Association, Survey Sampling International & Research Now



5

Statistical Notation

The statistical significance of a result in this survey is the probability that the observed relationship (e.g., between variables) or a difference (e.g., between means) in a sample occurred by pure chance, and that in the population from which the sample was drawn, no such relationship or differences exist. Using less technical terms, one could say that the statistical significance of a result tells us something about the degree to which the result is "true". More technically, the value of the p-value represents a decreasing index of the reliability of a result. The higher the p-value, the less we can believe that the observed relation between variables in the sample is a reliable indicator of the relation between the respective variables in the population. Specifically, the p-value represents the probability of error that is involved in accepting our observed result as valid, that is, as "representative of the population." For example, a p-value of .05 (i.e.,1/20) indicates that there is a 5% probability that the relation between the variables found in our sample is a "fluke."

The following statistical notations are used throughout the report:

= Indicates figure is significantly higher than other sub-group at a 95% confidence level (i.e. p-value of .05 or less).

C = Cardiologists

E = Electrophysiologists

N = Neurologists

P = General Practitioner (PCP/IM/FM)

Statistical Notation


6

Detailed Findings

Executive Summary


7

Physicians

A majority of physicians believe most Atrial Fibrillation patients don’t usually understand their increased risk of stroke and feel most patients underestimate the impact ischemic stroke can have on their lives.

Virtually all physicians (97%) agree that AFib-related ischemic stroke can have devastating outcomes.

More than one-half of physicians (55%) indicate their typical Atrial Fibrillation patient does not usually understand their risk of ischemic stroke due to Atrial Fibrillation.

Nine in ten physicians (90%) believe that many Atrial Fibrillation patients underestimate the impact an AFib-related stroke could have on their everyday lives.

Four in five physicians (79%) believe many AFib patients are in denial about their risk of experiencing an ischemic stroke.

Reducing the risk of Atrial Fibrillation-related ischemic stroke is almost always the primary objective when prescribing anticoagulation therapy. A variety of compliance barriers exist, and typically vary by specialty.

More than four in five physicians (85%) indicate their primary objective when prescribing anticoagulation therapy to patients with Atrial Fibrillation is to reduce the risk of AFib-related ischemic strokes.

However, bleeding (65%) and the overall safety profile of medication (62%) are leading concerns when prescribing anticoagulation therapy. Additionally, three in five Neurologists (62%) identify minimizing the risk of hemorrhagic stroke as a primary concern.

Four in five physicians (79%) believe too many patients underestimate the importance of adhering to their prescribed therapy for reducing the risk of AFib-related ischemic stroke.

Risk of bleeding is the largest compliance barrier for Electrophysiologists (35%) and Cardiologists (31%), while monitoring anti-coagulation effect is the most common barrier for Neurologists (53%) and General Practitioners (36%).

Executive Summary


8

Physicians (Cont’d.)

Physicians typically initiate conversations about the increased risk of AFib-related stroke and treatment. They see a variety of barriers to educating patients about their condition and seek support as they try to provide counsel.

Nine in every ten conversations (90%) between physicians and patients about increased risk of AFib-related stroke and available treatments are initiated by physicians.

Other than personally discussing their situation with patients (87% discuss condition, 82% to discuss treatment), there are no other widely used methods of patient education. Written materials are used by one-half of physicians (52%) for information on the condition, and less than one-half use them to educate about treatment options (45%).

In these discussions, the two most widely perceived barriers to educating Atrial Fibrillation patients is that they believe once their symptoms are being treated, the risk of AFib-related stroke goes away (43%) and patients feeling that the risks outweigh the benefits for medications reducing the risk of AFib-related stroke (41%).

More than four in five physicians (83%) wish they had more information/educational materials to share with their Atrial Fibrillation patients that discuss stroke risk associated with Atrial Fibrillation.

In terms of specific materials, three in four physicians (76%) would like to have educational brochures, pamphlets, or posters as resources to discuss stroke risk and treatment options with their Atrial Fibrillation patients and caregivers, and more than two in five (44%) would like web-based illustrations/animation.

Further, many physicians believe their colleagues are not doing enough to educate patients about the risk of ischemic stroke in Atrial Fibrillation patients and urge their peers to be mindful of the risk.

Three in four physicians (76%) regularly advise or remind their colleagues of the increased risk for ischemic stroke among Atrial Fibrillation patients.

Two in three physicians (67%) feel many of their colleagues don't do enough to educate Atrial Fibrillation patients about the risks of AFib-related ischemic strokes.

Executive Summary


9


The impact of Atrial Fibrillation and related stroke can be devastating, with a majority of survivors not even diagnosed prior to experiencing a stroke. Survivors wish they had known more about stroke, as there is a widely held belief that experiencing a stroke was worse than they could have imagined.

Three in five survivors (61%) did not know they suffered from Atrial Fibrillation prior to experiencing a stroke.

Only one-third of stroke survivors who spoke with their physician about Atrial Fibrillation (35%) discussed the impact of AFib-related stroke on everyday life.

Five in six stroke survivors (83%) wish they had known more about reducing the risk of an AFib-related stroke prior to experiencing a stroke.

More than three in four stroke survivors (77%) indicate their life has not been the same since experiencing an AFib-related stroke, and nearly three in four (73%) agree that experiencing a stroke was worse than they had imagined.

Although two-fifths of survivors don’t go out as much since having a stroke (40%) and have experienced depression (39%), three in five (60%) have attempted to live healthier lives.

Meanwhile, an alarming percentage of Atrial Fibrillation-only patients are not aware of nor understand the differences between different types of stroke, and couldn’t recognize the symptoms if one were to occur.

Less than one-half of Atrial Fibrillation-only patients (45%) are aware there are different stroke types, and less than two-fifths (38%) are familiar with ischemic stroke. When provided with a description, less then three in ten (28%) identified an obstruction within a blood vessel supplying blood to the brain as ischemic stroke.

One-third of Atrial Fibrillation-only patients (32%) don’t believe they would be able to describe the most common symptoms of stroke.

Most patients will eventually have a discussion with their physician about the increased risk of ischemic stroke, however many important issues are left out of conversation.

More than four in five Atrial Fibrillation patients (85%) have had a discussion with their physician about the increased risk of stroke due to Atrial Fibrillation.

However, more than one-third of patients (36%) were not initially informed by their physician that they may be at an increased risk of stroke.

Additionally, only two-thirds of AFib-only patients (65%) and less than one-half of survivors (48%) have discussed the risk of AFib-related stroke with and without medication.

On average, patients who have discussed the issue with their patients indicate they initiate the conversation 47% of the time – far different than reported by physicians (10%).

Executive Summary


10

Atrial Fibrillation Patients (Cont’d.)

Atrial Fibrillation patients are eager for information about how to reduce their personal risk of ischemic stroke. Despite this eagerness, many are not receiving materials that could provide further education.

Five in six AFib-only patients (87%) will seek to find out everything they can about Atrial Fibrillation and reducing their risk of AFib-related stroke.

More than four in five of all Atrial Fibrillation patients (82%) would be interested in learning more about how to reduce their risk of AFib-related ischemic stroke.

Less than one-half of patients (48%) indicate their physician gave them written materials to read regarding Atrial Fibrillation and the increased risk of AFib-related stroke.

Four in five AFib-only patients (80%) would like to have more information to take charge of their Atrial Fibrillation and learn about reducing the risk of AFib-related stroke.

There are a wide range of important facts about Atrial Fibrillation-related stroke that are unknown to a relatively high percentage of patients.

More than two in three Atrial Fibrillation patients (68%) were not previously aware that AFib-related strokes are nearly twice as likely to be fatal or disabling as non-AFib-related strokes.

More than one-third of Atrial Fibrillation patients (36%) were not previously aware that you can have 5 times greater risk for stroke if you are living with untreated Atrial Fibrillation.

Less than three in ten Atrial Fibrillation patients (27%) believed women had a higher risk of Atrial Fibrillation-related stroke than men.

Despite a lack of information, a high percentage of patients have taken medication and are compliant.

Six in seven patients who have discussed Atrial Fibrillation-related stroke with their physician (87%) have taken medication to reduce their risk of stroke. Oral anticoagulants (72%) are most commonly prescribed.

More than nine in ten patients who have taken medication (92%) regularly take their prescribed treatment to reduce their risk of AFib-related stroke.

Two in five patients who discussed an increased stroke risk with physicians (39%) named using a treatment that reduces the risk of a stroke caused by a blood clot in the brain to be the most important quality, and three in five (59%) named it as one of their two most important qualities.

Motor limitations are of primary concern in experiencing a stroke – one-third of patients (32%), including two-fifths of AFib-only patients (40%), indicated losing the ability to move, talk, or some other physical function concerns them most about having a stroke.

Executive Summary


11

Caregivers

Caregivers tend to provide assistance and care for stroke survivors who are in “worse shape” than the average survivor.

On average, caregivers are providing assistance to survivors during 47% of their everyday activities. Survivors that were interviewed had indicated they required assistance 12% of the time, with three-fifths (61%) not requiring any assistance at all.

One in seven caregivers (14%) provide assistance 100% of the time survivors are doing everyday activities, and one in two (50%) provide assistance at least half of the time survivors are doing everyday activities.

The survivors in their care are more likely to have experienced a range of limitations:

92% experienced motor limitations within their first 6 months, compared to 81% of the overall survivor population

94% of these survivors still experience motor limitations, compared to 80% of the overall population

81% experienced cognitive limitations within their first 6 months, compared to 52% of the overall survivor population

69% experienced sensory limitations within their first 6 months, compared to 54% of the overall survivor population

43% experienced vision limitations within their first 6 months, compared to 31% of the overall survivor population

This situation places a crushing burden on caregivers which impacts personal time, relationships and emotions.

More than nine in ten caregivers (92%) feel they have a lot more responsibilities since becoming a caregiver.

Nine in ten caregivers (91%) agree that their lives have not been the same since the person in their care experienced an AFib-related stroke.

Six in seven caregivers (86%) couldn’t have imagined the amount of work it takes to care for a stroke survivor.

Two in three caregivers (66%) don’t have as much time to do activities or hobbies that bring them joy.

Three in five caregivers (60%) feel like they have more to do than they can handle.

More than two in three caregivers (68%) feel their relationship is different with their patient since they suffered a stroke.

Nearly three in five caregivers (56%) feel more socially isolated.

Executive Summary


12

Caregivers (Cont’d.)

Despite this burden, caregivers are dedicated to assisting the survivor in their care and stay informed about Atrial Fibrillation and associated stroke risks, including being an active participant in the survivor’s medical care. Most of these caregivers are knowledgeable about ischemic stroke.

Nearly nine in ten caregivers (86%) indicated they were aware there were different types of strokes.

Three in four caregivers (76%) are familiar with ischemic stroke, and two-fifths are very familiar. Additionally, more than two in three caregivers (68%) were able to correctly identify an ischemic stroke as being caused by an obstruction within a blood vessel supplying blood to the brain.

Four in five caregivers (82%) accompany the survivor in their care to doctor’s appointments always or most of the time.

More than three in four caregivers who attend doctor visits (78%) indicate the survivor’s physician has directly discussed Atrial Fibrillation and the increased risk of stroke, and more than three-fifths of caregivers (62%) have themselves discussed the increased risk of stroke due to Atrial Fibrillation with the physician.

On average, caregivers indicated more than three in four (78%) conversations about treatments to reduce the risk of Atrial Fibrillation related stroke are initiated by the physician. This is more in line with what physicians have reported (90% of conversations) compared to Atrial Fibrillation patients (53%).

A majority of caregivers have not received written information from physicians and have been forced to search for it on their own. This has led to most caregivers reporting that they would have liked to had more information.

After the survivor in their care was diagnosed with Atrial Fibrillation, four in five caregivers (81%) tried to find out everything they could about it and reducing AFib-related stroke risk.

Less than two in five caregivers who attend doctor visits (38%) indicate physicians have given written materials to read regarding Atrial Fibrillation or the increased risk of AFib-related stroke.

Seven in ten caregivers (69%) have personally sought out information related to Atrial Fibrillation or AFib-related strokes.

Of caregivers who have researched Atrial Fibrillation, more than three-quarters (77%) obtained information from an association or website related specifically to heart conditions or AFib-related stroke and a slight majority (54%) looked at written materials.

Nine in ten caregivers (89%) would have liked to have had more information about Atrial Fibrillation and learned more about AFib-related stroke.

Executive Summary


13

Caregivers (Cont’d.)

Beyond information, many caregivers indicate they could benefit from various types of other assistance.

Five in six caregivers (83%) wish they had more support and information to take care of the survivor in their care.

Seven out of ten caregivers (70%) would find physical help useful in helping provide care.

More than three in five caregivers would find home modifications (63%), financial assistance (63%) and respite care (62%) useful in helping provide care.

Executive Summary


14

Detailed Findings: Physicians



15

Number of Atrial Fibrillation Patients See Per Year


Base: Total Respondents (n=507)

1a. In an average 12 month time period, how many patients with Atrial Fibrillation (AFib) do you see?

Electrophysiologists and Cardiologists see far more AFib patients than Neurologists and General Practitioners.

On average, physicians see a total of 160 Atrial Fibrillation patients each year. This ranges from 98 patients per year among Neurologists to 215 patients seen by the average Electrophysiologist.

More than two-fifths of physicians (42%) see 200 or more Atrial Fibrillation patients each year.

Seven in ten Electrophysiologists (73%) see 200 or more Atrial Fibrillation patients each year.

More than nine in ten Neurologists (92%) see less than 200 Atrial Fibrillation patients each year.

Under 100; 32%

100 To 199; 26%

200 or more; 42%

Specialty

Cardio-logist

Electro-physiologist

Neuro-logist

PCP/Internal/Family

Total Respondents

(202) (101) (53) (151)

% % % %

C E N P

Under 100 18 9 60 57

100 to 199 29 18 32 26

200 or more 53 73 8 17

Mean 187 215 98 108

E

E

NP CNP

CE

E

CE

Mean: 160

CNPNP


16

Percentage of Atrial Fibrillation Patients With History of Stroke



1b. And what percentage of your AFib patients have had a history of stroke?

The majority of AFib patients seen by Neurologists have a history of stroke.

On average, one-fifth of Atrial Fibrillation patients seen by physicians (20%) have a history of stroke.

More than one-half of patients seen by Neurologists (53%) have a history of stroke.

One-fifths of patients seen by General Practitioners (21%) have a history of stroke.

One in seven patients seen by Cardiologists (15%) have a history of stroke.

One in ten patients seen by Electrophysiologists (10%) have a history of stroke, and one-half of EPs (51%) indicate less than 10% of their Atrial Fibrillation patients have a history of stroke.

1 to 9 per-cent; 28%

10 to 24 percent; 44%

25 to 100 per-cent; 28%

Specialty

Cardio-logist


Neuro-logist

PCP/Internal/Family

Total Respondents

(202) (101) (53) (151)

% % % %

C E N P

1% to 9% 33 51 - 17

10% to 24% 50 43 21 44

25% to 100% 18 6 79 39

Mean 15 10 53 21

N

E

NP

CEP CE

N

CNP

N

Mean: 20%


17

Types of Oral Treatments Prescribe To Atrial Fibrillation Patients to Reduce Risk of Stroke



2. In terms of reducing the risk of stroke in Atrial Fibrillation, what types of oral treatment options do you currently prescribe to your at-risk patients?

Oral anticoagulants are universally prescribed to reduce the risk of stroke in Atrial Fibrillation patients.

Physicians universally prescribe oral anticoagulants to Atrial Fibrillation patients to reduce the risk of stroke (100%).

Four-fifths of physicians (79%) prescribe antiplatelets to Atrial Fibrillation patients to reduce the risk of stroke.

Antiplatelet

Oral anticoagulant

0 10 20 30 40 50 60 70 80 90 100

79

100


18

Oral Treatment Share of Prescription



3. What percentage of the time do you prescribe each of the following oral treatment options to your at-risk

patients with Atrial Fibrillation to reduce their risk of stroke?

Oral anticoagulants are prescribed in the vast majority of cases when treating at-risk patients with Atrial Fibrillation.

Four-fifths of oral treatment prescriptions (80%) made by physicians to at-risk patients with Atrial Fibrillation are oral anticoagulants.

Nearly nine in ten oral treatment prescriptions (88%) made by Electrophysiologists to at-risk patients with Atrial Fibrillation are oral anticoagulants.

More than one-quarter of oral treatment prescriptions (27%) made by General Practitioners to at-risk patients with Atrial Fibrillation are antiplatelets.

Oral an-ticoagu-

lant; 80%

An-tiplatelet; 20%

Specialty

Cardio-logist


Neuro-logist

PCP/Internal/Family

Total Respondents

(202) (101) (53) (151)

% % % % C E N P

Oral anticoagulant

82 88 78 73

Antiplatelet 17 12 22 27

P P

CE


19

Primary Objective When Prescribing Anticoagulation Therapy



4. Of the following options, which best describes your primary objective when prescribing anticoagulation therapy for

patients with Atrial Fibrillation?

Reducing the risk of AFib-related ischemic stroke is almost always the primary objective when physicians prescribe anticoagulation therapy.

More than four in five physicians (85%) indicate their primary objective when prescribing anticoagulation therapy to patients with Atrial Fibrillation is to reduce the risk of AFib-related ischemic strokes.

Seven percent of physicians indicate their primary objective when prescribing anticoagulation therapy to patients with Atrial Fibrillation is the overall safety profile of the medication.

Three percent of physicians indicate their primary objective when prescribing anticoagulation therapy to patients with Atrial Fibrillation is to minimize potential adverse effects.

Three percent of physicians indicate their primary objective when prescribing anticoagulation therapy to patients with Atrial Fibrillation is to minimize the risk of hemorrhagic strokes.

To reduce the risk of AFib-

related is-chemic

strokes; 85%

Overall safety profile of the medication;

7%

To minimize potential ad-verse effects;

3%To minimize the risk of

hemorrhagic strokes; 3%Other; 2%


20

Bleeding and the overall safety profile are leading concerns when prescribing anticoagulation therapy.

A patient’s bleeding risk is of primary concern to two in three physicians when prescribing anticoagulation therapy (65%) and it is the greatest concern to one in four physicians (25%).

The overall safety profile of the medication is of primary concern to more than three in five of physicians when prescribing anticoagulation therapy (62%) and it is the greatest concern to more than one in four physicians (27%).

Minimizing the risk of hemorrhagic strokes is of primary concern to one in two physicians when prescribing anticoagulation therapy (50%) and it is the greatest concern to one in seven physicians (14%).

Compliance is of primary concern to one in two physicians when prescribing anticoagulation therapy (49%) and it is the greatest concern to eight percent of physicians.

Concerns When Prescribing Anticoagulation Therapy



5a. When using anticoagulants to reduce the risk of stroke resultant from atrial fibrillation, what are your primary concerns?

5b. When using anticoagulants to reduce the risk of stroke resultant from atrial fibrillation, what do you see as the greatest concern?

Need for dual anti-platelet therapy

Patient preference

Dosing schedule for the patient

Food and drug interactions

Reversibility of the anticoagulant effect

Cost

Potential Adverse Events

Compliance

Minimizing the risk of hemorrhagic strokes

Overall safety profile of the medication

Patient's bleeding risk

- 10 20 30 40 50 60 70 80

1

2

1

0

6

6

10

8

14

27

25

18

18

26

28

29

37

35

41

36

35

40

19

20

27

29

35

43

45

49

50

62

65

Greatest Additional Total


21

Neurologists tend to have a broader range of concerns than other physicians when prescribing anticoagulation therapy.

Three in five Neurologists (62%) indicate minimizing the risk of hemorrhagic strokes is of primary concern when prescribing anticoagulation therapy. This is a significantly higher percentage when compared to Electrophysiologists (45%) and General Practitioners (46%), and was also higher when compared to Cardiologists (52%).

One in two Neurologists (49%) indicate reversibility of the anticoagulant effect is of primary concern when prescribing anticoagulation therapy. This is a significantly higher percentage when compared to Electrophysiologists (28%) and Cardiologists (34%), and was also higher when compared to General Practitioners (35%).

Primary Concerns When Prescribing Anticoagulation Therapy



5a. When using anticoagulants to reduce the risk of stroke resultant from atrial fibrillation, what are your primary concerns?

Total Concerns Specialty

TotalCardio-logist

Electro-physio-logist

Neuro-logist

PCP/Internal/Family

Total Respondents (507) (202) (101) (53) (151)% % % % %

C E N P

Patient's bleeding risk 65 65 59 68 68

Overall safety profile of the medication 62 63 62 64 61

Minimizing the risk of hemorrhagic strokes

50 52 45 62 46

Compliance 49 48 41 53 56

Potential Adverse Events 45 43 35 55 52

Cost 43 39 48 40 47

Reversibility of the anticoagulant effect

35 34 28 49 35

Food and drug interactions 29 29 26 34 28

Dosing schedule for the patient 27 28 24 23 30

Patient preference 20 20 16 15 23

Need for dual anti-platelet therapy 19 23 24 11 13 P P

CE

E

E

EP


22

Case Study Treatment Recommendation



6. Based on your experience, which of the following would you recommend for reducing this patient’s risk of stroke in atrial fibrillation?

When presented with a case study for reducing the risk of stroke in Atrial Fibrillation, an oral anticoagulant is selected for treatment by a majority of physicians.

Based on the case study, nearly two in three physicians (64%) would recommend an oral anticoagulant for reducing the patient’s risk of stroke in Atrial Fibrillation.

Based on the case study, nearly one in seven physicians (13%) would recommend a high-dose aspirin for reducing the patient’s risk of stroke in Atrial Fibrillation.

Based on the case study, nearly one in seven physicians (13%) would recommend a low-dose aspirin for reducing the patient’s risk of stroke in Atrial Fibrillation.

Based on the case study, seven percent of physicians would recommend a dual antiplatelet for reducing the patient’s risk of stroke in Atrial Fibrillation.

Oral anticoagu-lant; 64%Aspirin (low

dose); 13%

Aspirin (high dose); 13%

Dual an-tiplatelet (low dose Aspirin and other an-tiplatelet); 7%

Dual antiplatelet therapy (high dose Aspirin and other antiplatelet); 3%

A 67 year old woman with hypertension presents with recurrent episodes of paroxysmal atrial fibrillation. She has no other past medical history.

This patient has a CHADS2 score of 1 (hypertension) and CHA2DS2VASc score of 3 (hypertension, woman, age >65)


23

Treatment Conversation Initiation Percentage Share



7. Thinking about conversations you have had with your patients with Atrial Fibrillation about their increased risk of AFib-related stroke

and available treatments, what percentage of the time would you say conversations are initiated by you versus those initiated by patients?

Physicians almost always initiate discussions about the increased risk of AFib-related stroke and available treatments.

Nine in every ten conversations (90%) between physicians and patients about increased risk of AFib-related stroke and available treatments are initiated by physicians.

One in every ten conversations (10%) between physicians and patients about increased risk of AFib-related stroke and available treatments are initiated by patients.

Initiated by physician; 90%

Initiated by pa-tient; 10%


24

Risk of bleeding and other adverse events are often viewed as the leading barrier to initiating therapy.

A patient’s bleeding risk is the greatest barrier to three in ten physicians (31%) when initiating therapy to reduce the risk of stroke in patients with Atrial Fibrillation, and is within the three greatest concerns to more than one in two physicians (56%).

The risk of adverse events is the greatest barrier to nearly one in seven physicians (13%) when initiating therapy to reduce the risk of stroke in patients with Atrial Fibrillation, and is within the three greatest concerns to more than one in three physicians (35%).

Patient resistance is the greatest barrier to one in seven physicians (14%) when initiating therapy to reduce the risk of stroke in patients with Atrial Fibrillation, and is within the three greatest concerns to three in ten physicians (30%).

Affordability is the greatest barrier to one in ten physicians (10%) when initiating therapy to reduce the risk of stroke in patients with Atrial Fibrillation, and is within the three greatest concerns to one in three physicians (33%).

Three Greatest Barriers When Initiating Therapy To Reduce Risk Of Stroke



8. From your experience, which of the following do you view as the greatest, second greatest and third greatest barriers when initiating therapy to reduce the risk of stroke in patients with atrial fibrillation?

Lack of samples

Time to counsel patients on dietary restrictions

Lack of patient education resources

Unsure of patient's stroke risk

Dietary restrictions

Patient tolerability

Unsure of patient's bleed risk

Time to counsel patients on medication risks and benefits

Drug-drug interactions

Prior authorizations or managing insurance coverage

Routine lab work required for monitoring

Patient resistance

Patient risk of falling

Affordability

Risk of adverse events

Patient risk of bleeding

- 10 20 30 40 50 60

1

1

2

2

1

3

2

3

2

6

6

14

5

10

13

31

1

2

2

3

2

3

3

4

4

6

10

6

12

14

12

15

1

1

3

1

3

4

5

4

7

9

9

10

15

9

10

10

3

4

6

6

6

10

10

11

13

20

25

30

31

33

35

56

Greatest 2nd Greatest 3rd Greatest Total


25

The greatest barrier to initiating therapy often differs by physician specialty.

Patient resistance is the greatest barrier to nearly three in ten Electrophysiologists (28%), a significantly higher percentage when compared to all other physician segments.

Patient risk of bleeding is the greatest barrier to more than two in five Neurologists (43%), a significantly higher percentage when compared to General Practitioners (26%) and Electrophysiologists (23%).

Routine lab work required for monitoring is the greatest barrier to one in nine General Practitioners (11%), a significantly higher percentage when compared to Cardiologists (5%) and Electrophysiologists (1%).

Greatest Barrier When Initiating Therapy To Reduce Risk Of Stroke




Greatest Barrier Specialty

TotalCardio-logist


Neuro-logist

PCP/Internal/Family


C E N PPatient risk of bleeding 31 35 23 43 26 Patient resistance 14 15 28 2 8 Risk of adverse events 13 10 11 21 15 Affordability 10 11 17 4 7 Routine lab work required for monitoring 6 5 1 6 11


6 7 8 2 5

Patient risk of falling 5 4 3 8 5 Patient tolerability 3 2 1 2 5


3 1 4 2 4

Drug-drug interactions 2 2 - - 5 Unsure of patient's stroke risk 2 1 1 6 3 Unsure of patient's bleed risk 2 2 1 4 2 Lack of patient education resources 2 1 2 2 1 Dietary restrictions 1 1 - - 1 Lack of samples 1 1 - - 1


1 0 1 - 1

NP

E

CNP

C

EP

C

CE

E

NP


26

Electrophysiologists particularly see different barriers to therapy initiation.

Patient resistance is one of the three greatest barriers to nearly one in two Electrophysiologists (48%), a significantly higher percentage when compared to all other physician segments.

Affordability is one of the three greatest barriers to nearly one in two Electrophysiologists (47%), a significantly higher percentage when compared to all other physician segments.

Separately, patient risk of falling is one of the three greatest barriers to more than one in two Neurologists (53%), a significantly higher percentage when compared to all other physician segments.




Top Three Greatest Barriers Specialty

TotalCardio-logist


Neuro-logist

PCP/Internal/Family


C E N PPatient risk of bleeding 56 54 54 60 56 Risk of adverse events 35 32 33 42 38 Affordability 33 35 47 13 30 Patient risk of falling 31 35 22 53 26 Patient resistance 30 33 48 17 20 Routine lab work required for monitoring 25 19 15 26 40


20 22 22 11 21

Drug-drug interactions 13 12 7 17 16


11 8 18 8 11

Unsure of patient's bleed risk 10 10 8 19 8 Patient tolerability 10 13 4 11 9 Dietary restrictions 6 7 4 4 8 Unsure of patient's stroke risk 6 4 5 13 7 Lack of patient education resources 6 7 8 2 5


4 4 2 2 5

Lack of samples 3 4 2 2 3 Other 1 1 3 - -

N

E

NP

E

CNP

CNP

C

P

CEP

EP

C

N

CE

E

Three Greatest Barriers When Initiating Therapy To Reduce Risk Of Stroke


27

Greatest Barrier to Patient Compliance



9. From your experience, what do you see as the greatest barrier to patient compliance in treatment therapy to reduce the risk of ischemic stroke

due to AFib?

Monitoring anticoagulation effect and risk of bleeding are the largest compliance barriers, though it varies by physician specialty.

Monitoring anticoagulation effect is the greatest barrier to patient compliance for nearly three in ten physicians (28%), including more than one in two Neurologists (53%) and more than one in three General Practitioners (36%).

Patient concern about the risk of bleeding is the greatest barrier to patient compliance for one in four physicians (26%), including more than one in three Electrophysiologists (35%) and three in ten Cardiologists (31%).

Patient concern about cost is the greatest barrier to patient compliance for one in six physicians (17%), including one in five Electrophysiologists (21%) and Cardiologists (20%), and one in six General Practitioners (16%). However, it is the greatest barrier to only two percent of Neurologists.

Number of daily doses

Patients are more con-cerned about AFib symp-

tom management

Dietary restrictions

Patients experiencing side effects due to the

medication

Patient belief that they are at low-risk for stroke due

to atrial fibrillation

Patients are concerned about cost

Patients are concerned about the risk of bleeding

Monitoring anticoagulation effect

0 10 20 30 40

1

3

4

8

12

17

26

28

Specialty

Cardio-logist


Neuro-logist

PCP/InternalFamily

Total Respondents (202) (101) (53) (151)% % % % C E N P

Monitoring anti-coagulation effect 22 14 53 36

Patients are concerned about the risk of bleeding

31 35 23 14

Patients are concerned about cost 20 21 2 16

Patient belief that they are at low-risk for stroke due to atrial fibrillation

10 18 13 12

Patients experiencing side effects due to the medication

8 6 8 11

Dietary restrictions 4 3 - 5

Patients are more concerned about AFib symptom management

3 2 - 5

Number of daily doses 1 2 - 2

P P

N N

CEP CE

N


28

Level of Patient Understanding Regarding Increased Risk of Ischemic Stroke Due to Atrial Fibrillation



10. Overall, which of the following statements accurately describes your typical patient’s understanding of how Atrial Fibrillation

increases their risk of ischemic stroke?

A majority of AFib patients don’t usually understand their risk of ischemic stroke.

When asked to best describe the typical patient’s understanding of how Atrial Fibrillation increases their risk of ischemic stroke, more than one in two physicians (55%) indicate their average AFib patient does not usually understand their risk.

One in three physicians (34%) indicate their average AFib patient is actively looking for ways to reduce their risk of ischemic stroke.

One in five physicians (19%) indicate their typical AFib patient is very knowledgeable about their risk of ischemic stroke.

Two in three Electrophysiologists (65%) indicate their average AFib patient does not usually understand their risk of ischemic stroke.

Two in five Neurologists (43%) and General Practitioners (40%) indicate their average AFib patient is actively looking for ways to reduce their risk of ischemic stroke.

One in four Cardiologists (25%) indicate their typical AFib patient is very knowledgeable about their risk of ischemic stroke.

Specialty

Cardio-logist

Electro-physico-logist

Neuro-logist

PCP/Internal/Family

Total Respondents (202) (101) (53) (151)

% % % % C E N P

Average AFib patients do not usually understand their risk of ischemic stroke due to AFib

51 65 49 56

Average AFib patients are actively looking for ways to reduce their risk of ischemic stroke due to AFib

32 26 43 40

Typical AFib patients are very knowledge-able about their risk of ischemic stroke due to AFib

25 13 17 15

C

EP

E

Typical AFib patients are very knowledge-

able about their risk of ischemic stroke due to

AFib

Average AFib patients are actively looking for ways to reduce

their risk of ischemic stroke due to AFib

Average AFib patients do not usually under-stand their risk of is-chemic stroke due to

AFib

0 10 20 30 40 50 60

19

34

55

E


29

Patient Consideration Importance



11. How important do you think the following considerations are for your patients with Atrial Fibrillation?

Physicians believe a wide range of treatment option considerations are deemed important by Atrial Fibrillation patients.

Virtually all physicians indicate patients find it important to reduce the risk of stroke due to atrial fibrillation (96%).

More than nine in ten physicians indicate patients consider minimizing the risk of hemorrhagic stroke to be important (93%).

More than nine in ten physicians indicate patients consider being able to follow the treatment or dosing regimens to be important (92%).

More than nine in ten physicians indicate patients consider being able to afford their medication to be important (92%).

More than nine in ten physicians indicate patients consider understanding Atrial Fibrillation and the associated risk of stroke to be important (92%).

Nine in ten physicians indicate patients consider reducing the symptoms of Atrial Fibrillation to be important (90%).

Learning about ways to manage Atrial Fibril-lation

Learning about treatment options that may reduce their risk of AFib-related ischemic

stroke

Reducing the symptoms of Atrial Fibrillation

Understanding Atrial Fibrillation and the associated risk of stroke

Being able to afford their medication

Being able to follow the treatment or dosing regimens

Minimizing the risk of hemorrhagic stroke

Reducing the risk of stroke due to Atrial Fibril-lation

70 80 90 100

84

89

90

92

92

92

93

96

Very Important/ Important


30

Ways Attempt To Educate Patients With AFib About Specifics Of Condition & Increased Risk Of Atrial Fibrillation-Related Stroke



12. In which, if any, of the following ways do you try to educate your patients with Atrial Fibrillation about the specifics of their condition and their

increased risk of AFib-related stroke?

Direct discussion is the most universal method used to educate Atrial Fibrillation patients about increased risk of AFib-related stroke.

Nearly nine in ten physicians (87%) educate AFib patients about their condition by personally discussing the situation with them directly.

One in two physicians (52%) educate AFib patients about their condition by giving them written material to read.

Two in five physicians (40%) educate AFib patients about their condition by having a nurse, educator, or other professional in their office discuss their situation with them.

One in five physicians (21%) educate AFib patients about their condition by directing them to associations or websites related specifically to heart conditions or AFib-related stroke.

You direct them to download an app for a mobile phone, tablet computer or other device

Direct them to a pharmaceutical company website on the condition

Direct them to a pharmaceutical company website with information on medications to reduce risk of AFib-re-

lated stroke

You give them educational CDs or DVDs

Direct them to associations or websites related specif-ically to heart conditions or AFib-related stroke

Have a nurse, educator, or other professional in my of-fice discuss their situation with them

Give them written material to read

You personally discuss their situation with them directly

0 10 20 30 40 50 60 70 80 90 100

6

7

7

7

21

40

52

87


31

The belief that risk goes away, risks of treatment outweigh benefits, and difficulty in understanding the situation are all common barriers to patient education.

More than one in five physicians (22%) believe the primary barrier to educating Atrial Fibrillation patients is the feeling that the risks outweigh the benefits for medications reducing the risk of AFib-related stroke, and two in five (41%) view it as a barrier overall.

One in five physicians (22%) believe the primary barrier to educating Atrial Fibrillation patients is they think that once their symptoms are being treated, the risk of AFib-related stroke goes away, and more than two in five (43%) view it as a barrier overall.

One in six physicians (17%) believe the primary barrier to educating Atrial Fibrillation patients is they have trouble understanding what physicians are trying to explain to them, and two in five (40%) view it as a barrier overall.

Barriers To Educating Patients About Condition and Increased Risk for AFib-related stroke



13a. What do you see as barriers in terms of trying to educate your patients with Atrial Fibrillation about the specifics of their condition and their increased risk of AFib-related stroke?

13b. And what do you see as the primary barrier in terms of trying to educate your patients with Atrial Fibrillation about the specifics of their condition and their increased risk of AFib-related stroke?

Don't have any good websites to refer the patient to

Don't have literature to give them

They don't believe that Atrial Fibrillation can cause stroke

Don't have nurses, educators, or other professionals in my office available to discuss their situation with them

Don't have enough time to fully discuss the issues with them

They don't really believe that their condition is serious

They have trouble understanding what I am trying to explain to them (due to things such as age, cognitive issues, etc.)

They feel the risks outweigh the benefits for medications reducing the risk of AFib-related stroke

They think that once their symptoms are being treated, the risk of AFib-related stroke goes away

- 10 20 30 40 50

4

3

3

6

12

12

17

22

20

5

6

11

13

18

27

23

19

22

8

10

15

18

30

39

40

41

43

Primary Additional Total


32

Ways Attempt To Educate Patients With Atrial Fibrillation About Treatment Options



14. In which, if any, of the following ways do you try to educate your patients with Atrial Fibrillation about treatment options to reduce the risk of

AFib-related stroke?

Patient discussion and to a lesser extent, giving written materials, are the most common methods used to educate patients about treatment options.

More than four in five physicians (82%) attempt to educate AFib patients about treatment options by personally discussing the situation with them directly.

More than two in five physicians (45%) attempt to educate AFib patients about treatment options by giving them written material to read.

More than one in three physicians (36%) attempt to educate AFib patients about treatment options by having a nurse, educator, or other professional in their office discussion their situation with them.

One in five physicians (20%) attempt to educate AFib patients about treatment options by directing them to associations or websites related specifically to heart conditions or AFib-related stroke.

Direct them to download an app for a mobile phone, tablet computer or other device

Give them educational CDs or DVDs

Direct them to a pharmaceutical company website on the condition

Direct them to a pharmaceutical company website with in-formation on medications to reduce risk of AFib-related

stroke

Direct them to associations or websites related specifically to heart conditions or AFib-related stroke

Have a nurse, educator, or other professional in my office discuss the treatment options with them

Give them written material to read

Personally discuss the treatment options with them

0 10 20 30 40 50 60 70 80 90 100

6

7

7

7

20

36

45

82


33

Barriers To Educating Patients About Treatment Options



15a. What do you see as barriers in terms of trying to educate your patients with Atrial Fibrillation about treatment options to reduce the risk of AFib-related ischemic stroke?

15b. And what do you see as the primary barrier in terms of trying to educate your patients with Atrial Fibrillation about treatment s options to reduce the risk of ischemic stroke?

Don't have literature to give them

Don't have any good websites to refer the patient to

Don't have nurses, educators, or other professionals in my office available to discuss the treatment options with them

They don't believe that Atrial Fibrillation can cause an ischemic stroke

Don't have enough time to fully discuss the treatment options with them

They don't really believe that their AFib is serious and warrants medication

They think that once their symptoms are being treated, the risk of AFib-related stroke goes away

They feel the risks outweigh the benefits for medications reducing the risk of AFib-related stroke

They have trouble understanding what I am trying to explain to them (due to things such as age, cognitive issues, etc.)

- 10 20 30 40 50

2

4

7

6

14

13

16

21

19

6

4

9

13

12

18

20

16

20

8

8

16

18

26

31

36

37

39

Primary Additional Total

Difficulty in understanding key issues, believing risks of treatment outweigh benefits of medication, and the belief that risk goes away once treated are all common barriers to patient education about their potential treatment options to reduce the risk of AFib-related stroke.

One in five physicians (21%) believe the primary barrier to educating Atrial Fibrillation patients about treatment options is the feeling that the risks outweigh the benefits for medications reducing the risk of AFib-related stroke, and nearly two in five (37%) view it as a barrier overall.

One in five physicians (19%) believe the primary barrier to educating Atrial Fibrillation patients about treatment options is they have trouble understanding what physicians are trying to explain to them, and two in five (39%) view it as a barrier overall.

Nearly one in six physicians (16%) believe the primary barrier to educating Atrial Fibrillation patients about treatment options is they think that once their symptoms are being treated, the risk of AFib-related stroke goes away, and more than one in three (36%) view it as a barrier overall.


34

Resources Would Like At Disposal To Discuss Stroke Risk and Treatment Options With Patients



16. What resources would you like to have to discuss stroke risk and treatment options with your Atrial Fibrillation patients/caregivers?

The vast majority of physicians would like to have educational materials to discuss stroke risk and treatment options with patients.

Three in four physicians (76%) would like to have educational brochures, pamphlets, or posters as resources to discuss stroke risk and treatment options with their Atrial Fibrillation patients and caregivers.

More than two in five physicians (44%) would like to have web-based illustrations or animations as resources to discuss stroke risk and treatment options with their Atrial Fibrillation patients and caregivers.

One in three physicians (33%) would like to have interactive videos as a resource to discuss stroke risk and treatment options with their Atrial Fibrillation patients and caregivers.

One in four physicians (25%) would like to have on-demand FAQs as a resource to discuss stroke risk and treatment options with their Atrial Fibrillation patients and caregivers.

On-demand FAQs

Interactive videos

Web-based illustrations/animations

Educational brochures/pamphlets/posters

0 10 20 30 40 50 60 70 80 90 100

25

33

44

76


35

Atrial Fibrillation Statement Agreement



17. How much do you agree or disagree with each of the following statements in terms of treatment of Atrial Fibrillation?

Physicians see devastating outcomes from ischemic stroke and see Atrial Fibrillation patients underestimate or live in denial about their risk. Further, many physicians believe their colleagues are not doing enough to educate about these risks, and would like more information themselves.

Virtually all physicians (97%) agree that AFib-related ischemic stroke can have devastating outcomes.

Nine in ten physicians (90%) agree that many Atrial Fibrillation patients underestimate the impact an AFib-related stroke could have on their everyday lives.

More than four in five physicians (83%) wish they had more information/educational materials to share with their Atrial Fibrillation patients that discuss stroke risk associated with Atrial Fibrillation.

Four in five physicians (79%) believe many AFib patients are in denial about their risk of experiencing an ischemic stroke and four in five (79%) believe too many underestimate the importance of adhering to their prescribed therapy for reducing the risk of AFib-related ischemic stroke.

Three in four physicians (76%) regularly advise or remind their colleagues of the increased risk for ischemic stroke among Atrial Fibrillation patients, and two in three (67%) feel many of their colleagues don't do enough to educate Atrial Fibrillation patients about the risks of AFib-related ischemic stroke.

I feel many of my colleagues don't do enough to educate Atrial Fibrilla-tion patients about the risks of AFib-related ischemic stroke

I regularly advise or remind my colleagues of the increased risk for ischemic stroke among Atrial Fibrillation patients

I have too many Atrial Fibrillation patients who underestimate the im-portance of adhering to their prescribed therapy for reducing the risk of

AFib-related ischemic stroke

I believe many Atrial Fibrillation patients are in denial about their risk of experiencing an ischemic stroke

I wish I had more information/educational materials to share with my Atrial Fibrillation patients that discuss stroke risk associated with Atrial

Fibrillation

I wish I had more information/educational materials to share with my Atrial Fibrillation patients that discuss risks/ benefits of treatment op-

tions to reduce the risk of stroke in Atrial Fibrillation

Many Atrial Fibrillation patients underestimate the impact an AFib-re-lated stroke could have on their everyday lives

I believe that AFib-related ischemic stroke is more common than hemorrhagic stroke

I believe AFib-related ischemic stroke can be as debilitating as a hemorrhagic stroke

I think anticoagulants are effective stroke risk reduction treatments for the appropriate atrial fibrillation patient

AFib-related ischemic stroke can have devastating outcomes to my pa-tients/caregivers

60 70 80 90 100

67

76

79

79

83

84

90

94

95

97

97

Agree Strongly/Somewhat


36



Specialty

TotalCardio-logist

Electro-physico-

logistNeuro-logist

PCP/Internal/Family


Male 84 91 89 74 75 Female 16 9 11 26 25

Mean Age 47 48 47 45 46

Primary Care/Internal Medicine/Family Practice (net)

30 - - - 100

Primary care physician 7 - - - 23 Internal medicine 7 - - - 23 Family practice 16 - - - 55

Cardiologist 40 100 - - - Electrophysiologist 20 - 100 - - Neurologist 10 - - 100 -

Years In PracticeLess than 1 to 9 years 33 33 36 45 25 10 to 19 years 37 33 35 30 47 20 or more years 30 34 30 25 28

Mean # AFib Patients Treat 135 179 118 91 105Mean % of Time In Clinical Practice 94 94 92 92 97

Board-certified 97 98 97 91 97 Board-eligible 3 2 3 9 3

Mean Patient Age 62 63 63 62 60

Primary Work LocationPrivate practice 64 63 41 49 85 Hospital 33 36 51 49 12 Skilled nursing facility; LTAC 1 1 2 - - Other 2 - 5 2 3

Stroke Center AffiliationJoint Commission certified comprehensive stroke center

49 - - 49 -

Joint Commission certified primary stroke center

42 - - 42 -

CARF - certified stroke center 4 - - 4 - None of the above 17 - - 17 -

Physician Profile

NP

CE

P

NP

CE

CN

ENP

CEN

N N

CP

P P

P

E

CP P

CEN

C C


37

Detailed Findings: Patients



38

Type & Number of Strokes Experienced


E. What type of stroke did you experience?

F. In total, how many strokes have you experienced?

1 stroke;

63%

2 strokes;

19%

3 or more

strokes; 18%

Mean: 2Don't know

Combination of Hemorrhagic and

Ischemic

Hemorrhagic

Transient Ischemic Attack or TIA

Ischemic

0 10 20 30 40 50 60

9

8

16

35

53

Base: Total Stroke Survivors (n=251)

Ischemic strokes are most common and a considerable percentage of survivors experience multiple strokes.

A slight majority of survivors (53%) have experienced an ischemic stroke.

One in six caregivers (16%) indicate the person in their care has experienced a hemorrhagic stroke.

More than one in three survivors (35%) have experienced a Transient Ischemic Attack (TIA).

Nearly two in five survivors (37%) have experienced multiple strokes.


39

How Long Ago Most Recent Stroke Took Place



G. How long ago did your most recent stroke take place?

Less than 6 months ago; 8%

6 months to 11

months ago; 6%

1 to 2 years

ago; 26%

3 to 4 years ago; 28%

5 or more years

ago; 31%

Mean: 3.6 years

Most survivors experienced a stroke less than 5 years ago. Seven in ten survivors (69%) experienced their most recent stroke less

than 5 years ago.

One in seven survivors (14%) experienced their most recent stroke less than 1 year ago.


40

Time And Activities Where Assistance Is Required



H. When it comes to everyday activities (such as bathing, dressing, or toileting), keeping in mind you may need more help in

some areas, on average what percentage of the time do you need assistance? I. For what type(s) of everyday activities do you need assistance at least some of the time?

0 per-cent; 61%


20 or more per-cent; 22%

Base: Total Stroke Survivors Needing Assistance (n=99)

Housekeping/laundry/preparing

meals

Transferring (e.g. going from bed to chair)

Toileting

Feeding

Grooming

Bathing

Dressing

Taking medication

Moving/mobility

Shopping

Driving

0 10 20 30 40 50 60 70

5

14

15

15

21

31

33

36

41

49

51

Mean: 12%

While a majority of survivors don’t require assistance, those who do usually need it for activities outside of the home.

Two in five survivors (39%) require assistance in everyday activities.

One in two survivors who require assistance (51%) need assistance with driving.

One in two survivors who require assistance (49%) need assistance with shopping.

Two in five survivors who require assistance (41%) need assistance with moving/mobility.

More than one in three survivors who require assistance (36%) need assistance with taking medication.


41

Activities Experienced Difficulty Within First 6 Months Following Stroke


J. Did you experience difficulty or limitations with any of the following in the first six months OR as a result of your stroke?

TotalTotal Stroke Survivors (251)

% Experienced Limitations (net) 88

Motor (subnet) 81 Impaired balance 56 Walking 51 Speech 46 Hand movement 44 Leg movement 39 Arm movement 37

Affect (subnet) 60 Depression or sadness 45 Insomnia 29 Loss of appetite 20 Uncontrollable laughing or crying 20

Sensory (subnet) 54 Numbness 39 Tingling 30 Pain 28

Cognition (subnet) 52 Memory 45 Maintaining attention 31 Calculation abilities 19

Language (subnet) 33 Writing 27 Reading 22

Vision (subnet) 31 Impaired vision 26 Blindness 6 Other 3

Incontinence 18 Other 2

No limitations 12

Motor limitations, along with depression and memory issues, are the most common difficulties in the first six months following a stroke.

Four in five survivors (81%) indicate they experienced one or more motor limitations within the first 6 months of suffering a stroke.

More than one-half of survivors (56%) experienced impaired balance within the first 6 months of suffering a stroke.

One in two survivors (51%) experienced walking limitations within the first 6 months of suffering a stroke.

Nearly one-half of survivors (45%) experienced depression or sadness within the first 6 months of suffering a stroke.

Nearly one-half of survivors (45%) experienced memory issues within the first 6 months of suffering a stroke.


42

Motor Limitations Currently Experience


Base: Total Stroke Survivors Who Have Experienced Motor Limitations (n=204)

K. You {mentioned/indicated} that you had experienced motor limitations as a result of your stroke. Which of the following limitations, if any, are you still experiencing?

Motor limitations, and specifically balance issues, persist beyond the initial months of suffering a stroke.

Four in five survivors who initially experienced motor limitations (80%) continue to suffer from them.

One-half of survivors who initially experienced motor limitations (51%) continue to suffer from impaired balance.

Nearly two in five survivors who initially experienced motor limitations (37%) continue to suffer from walking limitations.

Nearly two in five survivors who initially experienced motor limitations (37%) continue to suffer from hand movement limitations.

No longer experience any lim-itations

Speech

Leg movement

Arm movement

Hand movement

Walking

Impaired balance

0 10 20 30 40 50 60 70 80

20

27

27

29

37

37

51


43

Awareness of Atrial Fibrillation Prior To Stroke



1a. Did you know that you had Atrial Fibrillation prior to experiencing a stroke?

Knew about Atrial

Fibrilla-tion

prior to stroke;

39%Did not know about Atrial

Fibrilla-tion until after the stroke;

61%

Most survivors did not know they had Atrial Fibrillation prior to experiencing a stroke.

Two in five survivors (39%) knew they suffered from Atrial Fibrillation prior to experiencing a stroke.

Three in five survivors (61%) did not know they suffered from Atrial Fibrillation prior to experiencing a stroke.


44

How Life Has Changed Since Atrial Fibrillation Diagnosis



1b. How has your life changed, or what are you doing differently, since you were diagnosed with Atrial Fibrillation?

No changes

Taking medications

Joined a support group

Afraid to exercise or do other strenuous activity

Don't go out as much

Do everything I can to learn about Atrial Fibrillation

Do everything I can to learn about reducing my risk of

stroke due to Atrial Fibrillation

Getting healthier – more ex-ercise, eating right, etc.

0 10 20 30 40 50 60

13

2

9

21

24

45

49

55

Atrial Fibrillatio

n OnlyStroke

SurvivorsTotal Respondents (248) (251)

% %

Has Changed (net) 85 89

Getting healthier – more exercise, eating right

52 58

Do everything I can to learn about reducing my risk of stroke due to Atrial Fibrillation

46 53


48 43

Don't go out as much 13 35


17 24

Joined a support group 4 15

Taking medications 2 2

No changes 15 11

A slight majority of AFib patients have attempted to become more healthy since diagnosis, however survivors are more likely to stay in more and join a support group.

More than one in two Atrial Fibrillation patients (55%) have attempted to get healthier since being diagnosed.

One in two Atrial Fibrillation patients (49%) indicate they have done everything they can to learn about reducing their risk of stroke due to Atrial Fibrillation since being diagnosed.

More than two in five Atrial Fibrillation patients (45%) indicate they have done everything they can to learn about Atrial Fibrillation since being diagnosed.

Stroke survivors (35%) are nearly three times as likely as AFib-only patients (13%) to indicate they don’t go out as much since being diagnosed.

One in seven stroke survivors (15%) have joined a support group since being diagnosed with Atrial Fibrillation, a significantly higher percentage when compared to AFib-only patients (4%).


45

Conditions Think Individual with Atrial Fibrillation Would Be At Increased Risk For Experiencing



2. Which, if any, of the following conditions do you think a person with Atrial Fibrillation would be at an increased risk for experiencing?

None

Sleep apnea

Fainting

Chronic fatigue

High blood pressure

Difficulty breathing/ shortness of breath

Heart attack

Heart palpitations

Irregular heartbeat

Stroke

0 102030405060708090

3

28

38

46

47

48

49

64

78

80 Atrial

Fibrillation Only

Stroke Survivors

Total Respondents (248) (251)

% %

Stroke 78 81

Irregular heartbeat 85 71

Heart palpitations 72 57

Heart attack 45 53


54 43

High blood pressure 41 52

Chronic fatigue 42 51

Fainting 43 33

Sleep apnea 27 30

None of the above 1 6

Most Atrial Fibrillation patients understand there is an increased risk of stroke, regardless of whether they’ve experienced one in the past.

Four in five Atrial Fibrillation patients (80%) believe a person with Atrial Fibrillation would be at an increased risk of stroke.

Nearly four in five Atrial Fibrillation-only patients (78%) believe a person with Atrial Fibrillation would be at an increased risk of stroke

Stroke survivors are significantly more likely than AFib-only patients to believe a person with Atrial Fibrillation would be at increased risk of high blood pressure (52% vs. 41%) and chronic fatigue (51% vs. 42%).

AFib-only patients are significantly more likely than stroke survivors to believe a person with Atrial Fibrillation would be at increased risk of irregular heartbeat (85% vs. 71%), heart palpitations (72% vs. 57%), difficulty breathing (54% vs. 43%), and fainting (43% vs. 33%).


46

Conditions Physician Indicated At Increased Risk For Experiencing As Result Of Atrial Fibrillation



3. When you were first diagnosed with Atrial Fibrillation, which, if any, of the following did your physician indicate you may be at an increased risk for experiencing as a result of Atrial Fibrillation?

None of the above

Sleep apnea

Fainting

Chronic fatigue


High blood pressure

Heart attack

Heart palpitations

Irregular heartbeat

Stroke

0 10 20 30 40 50 60 70 80

9

15

17

20

25

27

32

38

57

64

Atrial Fibrillation

OnlyStroke


% %

Stroke 61 67



Heart attack 27 37



28 23


Fainting 18 17

Sleep apnea 14 16

None of the above 4 14

A considerable percentage of Atrial Fibrillation patients were not informed by a physician of their increased risk of stroke.

Nearly two in three Atrial Fibrillation patients (64%) were informed by a physician that they may be at increased risk of stroke as a result of Atrial Fibrillation – more than one-third (36%) were not informed.

Nearly three in five Atrial Fibrillation patients (57%) were informed by a physician that they may be at increased risk of irregular heartbeat as a result of Atrial Fibrillation.

Atrial Fibrillation-only patients are significantly more likely than stroke survivors to indicate they were informed of an increased risk of irregular heartbeat (64% vs. 50%) and heart palpitations (43% vs. 33%) as a result of Atrial Fibrillation.

Stroke survivors are significantly more likely than Atrial Fibrillation-only patients to indicate they were informed of an increased risk of heart attack (37% vs. 27%), high blood pressure (34% vs. 19%) and chronic fatigue (26% vs. 14%) as a result of Atrial Fibrillation.


47

Condition Concern



4a. How concerned are you in terms of experiencing any of the following as a result of Atrial Fibrillation?

Sleep apnea

Fainting

Chronic fatigue


High blood pressure

Heart palpitations

Heart attack

Irregular heartbeat

Stroke

39

43

56

58

58

63

68

72

84

Very/Somewhat Concerned Atrial Fibrillation

OnlyStroke


% %

Stroke 81 86


Heart attack 72 64



66 50



Fainting 51 36

Sleep apnea 42 36

Most Atrial Fibrillation patients are concerned about experiencing a stroke, while AFib-only patients have a wider range of concerns than stroke survivors.

More than four in five Atrial Fibrillation patients (84%) are concerned about stroke as a result of Atrial Fibrillation.

More than seven in ten Atrial Fibrillation patients (72%) are concerned about irregular heartbeat as a result of Atrial Fibrillation.

Atrial Fibrillation-only patients are significantly more likely than stroke survivors to be concerned about irregular heartbeat (81% vs. 62%), heart palpitations (72% vs. 53%), difficulty breathing/shortness of breath (66% vs. 50%), and fainting (51% vs. 36%) as a result of Atrial Fibrillation.


48

Ways Life Has Changed Since Having A Stroke



4b. How has your life changed, or what are you doing differently, since having a stroke?

Although many survivors experience negative emotional consequences, a majority aim for positive change.

Three in five stroke survivors (60%) are getting healthier since having a stroke.

One in two stroke survivors (48%) are doing everything they can to learn about Atrial Fibrillation since experiencing a stroke.

Two in five stroke survivors (40%) don’t go out as much since experiencing a stroke.

Two in five stroke survivors (39%) have experienced depression since experiencing a stroke.

No changes


Afraid to exercise or do other stren-uous activity

Experienced depression



Getting healthier – more exercise, eat-ing right, etc.

0 10 20 30 40 50 60 70

10

17

23

39

40

48

60


49

Stroke Type Familiarity



5a. How familiar are you with the term Ischemic Stroke? 5b. How familiar are you with the term Hemorrhagic Stroke?

5c. How familiar are you with the term Transient Ischemic Attack (TIA)?

A slight majority of AFib patients are familiar with ischemic stroke.

More than one in two survivors (55%) indicate familiarity with ischemic stroke.

One in two survivors (51%) indicate familiarity with hemorrhagic stroke.

Two in three survivors (65%) indicate familiarity with Transient Ischemic Attack (TIA).

0

10

20

30

40

50

60

70

80

90

100

27 25 32

28 26

33

22 24

13

24 26 22

Not at all familiar

Not very familiar

Somewhat familiar

Very famil-iar

55 51 65 IH

H

H

TT


50






Most Atrial Fibrillation-only patients are not familiar with ischemic stroke.

More than three in five AFib-only patients (62%) are not familiar with ischemic stroke.

More than three in five AFib-only patients (62%) are not familiar with hemorrhagic stroke.

Stroke survivors are significantly more likely than Atrial Fibrillation-only patients to be familiar with transient ischemic stroke (TIA) (78% vs. 51%) , ischemic stroke (72% vs. 38%), and hemorrhagic stroke (63% vs. 38%).

Atrial

Fib

rilla

t...

Stroke

Sur

vi...

Atrial

Fib

rilla

t...

Stroke

Sur

vi...

Atrial

Fib

rilla

t...

Stroke

Sur

vi...

0

10

20

30

40

50

60

70

80

90

100

12

41

13

37

17

46 26

30

25

26

34

32

28

16

27

20

17

10 35

13

35

17

31

12 Not at all familiar

Not very familiar

Somewhat familiar

Very familiar

72 63 78

== Ischemic == = Hemorrhagic = ==== TIA ====

513838


51

Stroke Type Identification: Obstruction Within Blood Vessel Supplying Blood to the Brain



5d. To the best of your knowledge, which type of stroke occurs as a result of an obstruction (i.e., clot or blockage) within a blood vessel supplying blood to the brain?

Most Atrial Fibrillation-only patients are unaware of the definition of ischemic stroke.

Overall, two-fifths of Atrial Fibrillation patients (42%) correctly identified an ischemic stroke as being caused by an obstruction within a blood vessel supplying blood to the brain.

Less than three in ten AFib-only patients (28%) correctly identified an ischemic stroke as being caused by an obstruction within a blood vessel supplying blood to the brain.

Stroke survivors were significantly more likely than Atrial Fibrillation-only patients to properly identify ischemic stroke (55% vs. 28%).

Don't know/not

sure

Hemorrhagic Stroke

Transient Is-chemic Attack

(TIA)

Ischemic Stroke

0 10 20 30 40 50 60

32

13

13

42

Atrial Fibrillation

OnlyStroke

Survivors


% %

Ischemic Stroke 28 55

Transient Ischemic Attack (TIA)

13 14

Hemorrhagic Stroke 15 11

Don't know/not sure 44 21


52

Stroke Type Identification: Ruptured Blood Vessel That Bleeds Into Surrounding Brain


5e. To the best of your knowledge, which type of stroke occurs as a result of a weakened blood vessel that ruptures and bleeds into the surrounding brain?

AFib-only patients are more likely to be able to correctly identify hemorrhagic stroke.

Two in three Atrial Fibrillation patients (66%) correctly identified a hemorrhagic stroke as being the result of a ruptured blood vessel that bleeds into the surrounding brain.

Three in four stroke survivors (75%) correctly identified a hemorrhagic stroke as being the result of a ruptured blood vessel that bleeds into the surrounding brain.

Nearly three in five Atrial Fibrillation-only patients (58%) correctly identified a hemorrhagic stroke as being the result of a ruptured blood vessel that bleeds into the surrounding brain.

Stroke survivors were significantly more likely than Atrial Fibrillation-only patients to properly identify hemorrhagic stroke (75% vs. 58%).


Don't know/not

sure

Ischemic Stroke


(TIA)

Hemorrhagic Stroke

0 10 20 30 40 50 60 70 80

23

4

7

66

Atrial Fibrillation

OnlyStroke

Survivors


% %

Hemorrhagic Stroke 58 75

Transient Ischemic Attack (TIA)

7 7

Ischemic Stroke 3 4

Don't know/not sure 32 15


53

Stroke Type Believed To Occur Most Often In AFib Patients



5f. In AFib, which type of stroke do you think occurs more often?

A majority of patients were unable to identify ischemic stroke as the most common type of stroke.

Two in five Atrial Fibrillation patients (41%) believe ischemic stroke occurs most often in people diagnosed with Atrial Fibrillation.

Three in ten Atrial Fibrillation patients (31%) are unsure what type of stroke occurs most often in people diagnosed with Atrial Fibrillation.

Total Atrial Fibrillation Only

Stroke Survivors0

10

20

30

40

50

60

70

80

90

100

41 42 40

5 7 3

22 18 27

31 33 30 Don't know/ not sure

Transient Is-chemic Attack (TIA)

Hemorrhagic Stroke

Ischemic Stroke


54

Prior Awareness of Different Stroke Types



5g. Prior to today, were you aware there were different types strokes?

AFib-only patients are less knowledgeable than survivors in terms of stroke types.

Overall, two in three Atrial Fibrillation patients (65%) indicated prior awareness of different types of strokes.

Stroke survivors are significantly more likely to be aware of the existence of different types of strokes (74% vs. 55% of Atrial Fibrillation-only patients).


Stroke Survivors0

10

20

30

40

50

60

70

80

90

100

65 55

74

35 45

26

Not Previously Aware

Previously Aware


55

Future Stroke Concern



6a. How concerned are you that you might experience an AFib-related Ischemic Stroke in the future? 6c. How concerned are you that you might experience a Hemorrhagic Stroke in the future?

6e. How concerned are you that you might experience an AFib-related Transient Ischemic Attack (a mini-stroke) in the future?

Most patients are concerned about experiencing a stroke in the future.

Three in four Atrial Fibrillation patients (76%) are concerned they might experience an ischemic stroke in the future.

Three in four Atrial Fibrillation patients (75%) are concerned they might experience a Transient Ischemic Attack (TIA) in the future.

Two in three Atrial Fibrillation patients (65%) are concerned they might experience a hemorrhagic stroke in the future.

Hemorrhagic stroke


Ischemic stroke

50 60 70 80 90 100

65

75

76

Very/ Somewhat Concerned

Atrial Fibrillation

OnlyStroke

Survivors


% %

Ischemic stroke 76 76

Transient Ischemic Attack

76 75

Hemorrhagic stroke 67 63


56

Interest In Learning More About Reducing Risk Of Stroke



6b. How interested would you be in learning more about how to reduce your risk of an AFib-related Ischemic Stroke? 6d. How interested would you be in learning more about how to reduce your risk of a Hemorrhagic Stroke?

6f. How interested would you be in learning more about how to reduce your risk of an AFib-related Transient Ischemic Attack (a mini-stroke)?

Patients want to learn more about reducing risk of all types of stroke.

More than four in five Atrial Fibrillation patients (82%) are interested in learning more about reducing the risk of ischemic stroke.

More than four in five Atrial Fibrillation patients (82%) are interested in learning more about reducing the risk of Transient Ischemic Attack.

Three in four Atrial Fibrillation patients (76%) are interested in learning more about reducing the risk of hemorrhagic stroke.

A significantly higher percentage of Atrial Fibrillation-only patients are interested in learning more about reducing the risk of Transient Ischemic Attack (86% vs. 78% of survivors) and hemorrhagic stroke (83% vs. 69%).

Hemorrhagic stroke


Ischemic stroke

50 60 70 80 90 100

76

82

82

Very/ Somewhat Interested

Atrial Fibrillation

OnlyStroke

Survivors


% %

Ischemic stroke 85 79

Transient Ischemic Attack

86 78

Hemorrhagic stroke 83 69


57

Primary Concern About Having A Stroke



6g. What concerns you most about having a stroke?

Motor limitations and loss of independence concern patients most when it comes to experiencing a stroke.

One-third of Atrial Fibrillation patients (32%) indicate their primary concern about having a stroke is losing the ability to move, talk, or some other physical function.

Two in five Atrial Fibrillation-only patients (40%) indicate their primary concern about having a stroke is losing the ability to move, talk, or some other physical function, significantly higher than stroke survivors (24%).

One in five stroke survivors (20%) indicate their primary concern about having a stroke is loss of independence, significantly higher than AFib-only patients (13%).

One in seven Atrial Fibrillation patients (15%) indicate their primary concern about having a stroke is being dependent on someone else.

Not concerned with having a stroke

Feelings of isolation

Being unable to do my current job

No longer being able to enjoy activities or hobbies

Financial burdens on me and my family

Death

Being dependent on someone else

Loss of independence

Losing the ability to move, talk, or some other physical function

0 10 20 30 40 50

7

2

4

6

8

10

16

20

24

3

1

2

5

8

13

14

13

40

5

1

3

5

8

11

15

17

32

Total

AFib Only

Stroke Survivor


58

Whether Physician Ever Discussed Increased Risk of Stroke Due To Atrial Fibrillation


Base: Total Not Told Of Increased Stroke Risk (n=179)

7. Has your physician ever discussed with you the increased risk of stroke due to Atrial Fibrillation?

A majority of Atrial Fibrillation patients not initially told of an increased stroke risk were eventually informed by their physician.

Nearly three in five patients who were not told of an increased stroke risk (58%) have had a discussion with their physician about their increased risk of stroke due to Atrial Fibrillation.

More than three in five stroke survivors who were not told of an increased stroke risk (63%) have had a discussion with their physician about their increased risk of stroke due to Atrial Fibrillation.

More than one in two AFib-only patients who were not told of an increased stroke risk (53%) have had a discussion with their physician about their increased risk of stroke due to Atrial Fibrillation.

Overall, more than four in five Atrial Fibrillation patients (85%) have had a discussion with their physician about their increased risk of stroke due to Atrial Fibrillation.


Stroke Survivors0

10

20

30

40

50

60

70

80

90

100

58 53 63

42 47 37

Physician has not discussed increased risk of stroke due to Atrial Fibril-lation

Physician has discussed in-creased risk of stroke due to Atrial Fibrilla-tion

Total % 85% 82% 88%


59

Atrial Fibrillation Stroke Treatment Conversation Initiation


Base: Total Ever Discussed Increased Stroke Risk With Doctor (n=423)

8. Thinking about conversations you have had with your physician about increased risk of AFib-related stroke and available

treatments to reduce the risk of AFib-related stroke, what percentage of the time would you say conversations are initiated by you versus those initiated by your physician?

Patients believe there is a near equal initiation of conversation with physicians regarding increased risk of Atrial Fibrillation-related stroke and available treatments.

On average, patients indicate they initiate nearly one-half (47%) of conversations about increased risk of AFib-related stroke and available treatments to reduce the risk of AFib-related stroke.

On average, patients indicate physicians initiate a slight majority (53%) of conversations about increased risk of AFib-related stroke and available treatments to reduce the risk of AFib-related stroke.

Initi-ated

by pa-tient; 47%

Initi-ated by

physician; 53%

Atrial Fibrillation

OnlyStroke

Survivors

Total Discussed Increased Risk Of Stroke With Doctor

(203) (220)

% %

Initiated by physician 56 50

Initiated by patient 44 50


60

Ways Physician Has Discussed Specifics of Atrial Fibrillation & Increased Risk Of Atrial Fibrillation-Related Stroke


9a. In which, if any, ways has your physician discussed the specifics of your condition and increased risk of AFib-related stroke?

Direct discussion and written materials are the most common form of education by physicians about increased risk of AFib-related stroke.

Six in seven Atrial Fibrillation patients (87%) indicate their physician has discussed their situation with them directly.

Less than one-half of patients (48%) indicate their physician gave them written materials to read regarding Atrial Fibrillation and the increased risk of AFib-related stroke.

One in four Atrial Fibrillation patients (25%) indicate a nurse, educator, or other professionals in their physician’s office has discussed their situation with them.

Prescribed medication

You were directed to download an app for a mobile phone, tablet computer or other device

Directed you to a pharmaceutical company's website that focused on the condition

You were given educational CDs or DVDs

Directed you to a pharmaceutical company's website that had information on medications to reduce the risk of

AFib-related stroke

Directed you to associations or websites related specif-ically to heart conditions or AFib-related stroke

A nurse, educator, or other professional in their office discussed your situation with you

Gave you written material to read (e.g. brochures, pamphlets, etc.)

Your physician discussed your situation with you directly

0 10 20 30 40 50 60 70 80 90 100

1

5

7

9

9

11

28

47

86

2

2

4

5

6

12

21

48

87

1

4

6

7

7

11

25

48

87

Total

Atrial Fibrillation Only

Stroke Survivors

Base: Total Discussed With Doctor Increased Risk of Stoke (n=423)


61

Level Of Satisfaction With Information Provided By Physician


9b. Overall, how satisfied were you with the information provided by your physician about your condition and increased risk of AFib-

related stroke? Were you…

Atrial Fibrillation patients are mostly satisfied with the information that was provided to them by their physician.

Nine in ten patients (89%) are satisfied with the information provided by their physician about their condition and increased risk of AFib-related stroke.

More than nine in ten AFib-only patients (93%) are satisfied with the information provided by their physician about their condition and increased risk of AFib-related stroke, significantly higher than the level of satisfaction among stroke survivors (86%).


Stroke Survivors0

10

20

30

40

50

60

70

80

90

100

48 47 50

41 45 36

8 5 10

3 2 4

Not at all satisfied

Not very satisfied

Somewhat satisfied

Very satis-fied

Base: Total Discussed With Doctor Increased Risk of Stoke (n=423)

89 8693


62

Information Sources Would Like Physician To Provide More Often


9c. Which of the following would you like more of from your physician on the specifics of your condition and increased risk of AFib-

related stroke?

Among patients who are dissatisfied with provided information or those who have not discussed their situation with physicians, direct discussion and written materials are both wanted.

Three in five Atrial Fibrillation patients who are dissatisfied with provided information or have not discussed their increased risk of stroke with physicians (62%) would like to discuss their situation directly with their physician.

Stroke survivors (71%) are significantly more likely than Atrial Fibrillation-only patients (53%) to want to speak with their doctor directly.

More than one in two Atrial Fibrillation patients who are dissatisfied with provided information or have not discussed their increased risk of stroke with physicians (55%) want written materials to read.

None

An app that can be downloaded for a mobile phone, tablet computer or other device

Information on a pharmaceutical company's website that has information on medications

to reduce the risk of stroke

Information on a pharmaceutical company's website that focuses on the condition

Educational CDs or DVDs

Information on associations/websites related specifically to heart conditions or stroke

Discussion of your situation with a nurse, educator, or other professional in your

physician's office

Written material to read

Discussion of your situation directly with your physician

0 10 20 30 40 50 60 70 80

2

8

13

15

18

29

31

53

71

-

12

15

15

33

40

40

57

53

1

10

14

15

25

34

35

55

62

Total


Stroke Survivors

Base: Total Not Satisfied With Information/Have Not Discussed With Doctor (n=122)


63

Topics of Discussion With Physician Regarding Atrial Fibrillation-Related Stroke


10. Has your physician ever discussed with you any of the following regarding stroke?

A majority of stroke survivors who spoke with a physician about increased risk of stroke never had a discussion regarding their risk with and without medication.

Less than one in two stroke survivors who spoke with their physician about Atrial Fibrillation (48%) discussed the risk of stroke with and without medication.

Two in three AFib-only patients who spoke with their physician about Atrial Fibrillation (65%) discussed the risk of stroke with and without medication – significantly higher than for stroke survivors.

One in two stroke survivors who spoke with their physician about Atrial Fibrillation (50%) discussed the symptoms of AFib-related stroke – significantly higher than for AFib-only patients (35%).

None of the above

Impact of AFib-related stroke on everyday life

Actions to take if witnessing or experienc-ing symptoms of AFib-related stroke

Symptoms of AFib-related stroke

Your risk of having AFib-related stroke with and without medication

0 10 20 30 40 50 60 70 80 90 100

27

35

42

50

48

18

25

37

35

65

23

30

40

43

56

Total


Stroke Survivors

Base: Total Discussed Increased Risk Of Stroke With Doctor (n=423)


64

Prevention of ischemic stroke is the most widely cited quality in treatment.

Two in five patients who discussed an increased stroke risk with physicians (39%) named using a treatment that reduces the risk of a stroke caused by a blood clot in the brain to be the most important quality, and three in five (59%) named it as one of their two most important qualities.

More than one in five patients who discussed an increased stroke risk with physicians (22%) named using a treatment which causes the least side effects to be the most important quality, and more than two in five (43%) named it as one of their two most important qualities.

One in seven patients who discussed an increased stroke risk with physicians (14%) named using a treatment that minimizes the risk of a stroke caused by a bleed in the brain to be the most important quality, and two in five (40%) named it as one of their two most important qualities.

Most Important Qualities In Treatment Designed To Reduce Risk Of Stroke From Atrial Fibrillation


11a. When discussing treatment options to reduce your risk of stroke in atrial fibrillation with your doctor, which of the following is most important to you?

11b. And when discussing treatment options to reduce your risk of stroke in atrial fibrillation with your doctor, which of the following is second most important to you?

No answer

Being affordable

Finding a treatment that is easy to use (e.g. once a day, etc.)

Using a treatment that minimizes the risk of a stroke caused by a bleed in the brain

Using a treatment which causes the least side effects

Using a treatment that reduces the risk of a stroke caused by a blood clot in the brain

- 10 20 30 40 50 60 70

0

11

12

14

22

39

1

12

19

26

21

20

1

23

32

40

43

59

Most 2nd Most Total

Base: Total Discussed Increased Stroke Risk With Doctor (n=423)


65

Whether Ever Taken Medications And Types Prescribed To Reduce Risk Of Atrial Fibrillation-Related Stroke


12. Has your physician ever had you take medications to reduce the risk of AFib-related stroke?

13a. To the best of your knowledge, what type(s) of treatment options has your physician prescribed in order to reduce the risk of AFib-related stroke?

Most patients who have discussed AFib-related stroke with their physician has taken oral anticoagulants for treatment.

Six in seven patients who have discussed Atrial Fibrillation-related stroke with their physician (87%) have taken medication to reduce their risk of stroke.

More than seven in ten patients who have taken medication to reduce their risk of AFib-related stroke (72%) have been prescribed an oral anticoagulant.

One in two patients who have taken medication to reduce their risk of AFib-related stroke (49%) have been prescribed an antiplatelet.

Antiplatelet

Oral anticoagulant

0 10 20 30 40 50 60 70 80

49

73

49

72

49

72


Stroke Survivor

Base: Total Have Taken Medication (n=369)Base: Total Discussed Atrial Fibrillation-Related Stroke Risk With Doctor (n=423)

0

10

20

30

40

50

60

70

80

90

100

87 86 88

13 14 12

Not Taken Medication

Taken Med-ication


66

Whether Regularly Takes Prescribed Treatment


Base: Total Have Taken Medication (n=369)

13b. Do you regularly take the treatment prescribed by your doctor?

The vast majority of Atrial Fibrillation patients that have taken medication are compliant, with AFib-only patients comprising the small percentage who are not taking their medication.

More than nine in ten patients who have taken medication (92%) regularly take their prescribed treatment to reduce their risk of AFib-related stroke.

Atrial Fibrillation-only patients are significantly more likely than stroke survivors to have stopped taking their prescribed treatment (9% vs. 4%).


Stroke Survivors0

10

20

30

40

50

60

70

80

90

100

92 88 96

2 3

1 6 9 4

Have stopped taking pre-scribed treatment

Do not regu-larly take prescribed treatment

Regularly take prescribed treatment


67

Gender Believe Has Higher Risk Of Atrial Fibrillation-Related Stroke & Whether Able To Describe Most Common Symptoms



14. Who do you think has a higher risk of experiencing an AFib-related stroke?15. If asked, do you believe that you would be able to describe to someone the most common symptoms of a stroke?

0

10

20

30

40

50

60

70

80

90

100

24 24 24

27 23 31

49 53 45

No dif-ference

Women

Men

0

10

20

30

40

50

60

70

80

90

100

78 68

88

22 32

12

Not able to describe most common symptoms of stroke

Able to de-scribe most common symptoms of stroke

A considerable percentage of AFib-only patients could not describe the most common stroke symptoms.

One in three Atrial Fibrillation-only patients (32%) feel they are not able to describe the common symptoms of stroke.

Nearly nine in ten stroke survivors (88%) feel they are able to describe the common symptoms of stroke.

Few Atrial Fibrillation patients know that women at are at higher risk of Atrial Fibrillation-related stroke.

More than one in four Atrial Fibrillation patients (27%) believe women have a higher risk of experiencing an AFib-related stroke. Survivors (31%) are significantly more likely than AFib-only patients (23%) to believe women are at greater risk.

One in four patients (24%) believe men have a higher risk of experiencing an AFib-related stroke.

One-half of patients (49%) do not believe either gender has a higher risk of experiencing an AFib-related stroke.


68

Symptoms Of Stroke


16a. To the best of your knowledge, which, if any, of the following are symptoms of someone experiencing a stroke?

Sudden chest pain

Sudden palpitations

Sudden shortness of breath

Sudden nausea

Sudden face and limb pain

A sudden, severe headache that is different from past headaches

Sudden dizziness

Sudden general weakness

Sudden vision changes

Sudden confusion or trouble understanding simple statements

Sudden problems with walking or balance

Sudden numbness/tingling/weakness/loss of movement in face/arm/leg, especially on only one side of your body

Sudden trouble speaking

10 20 30 40 50 60 70 80 90 100

18

24

28

29

53

61

59

67

64

80

83

86

87

24

31

33

34

51

54

58

56

70

79

78

85

90

21

27

30

32

52

58

58

62

67

80

81

86

89

Total


Stroke Survivors


Speaking and loss of movement are the most widely thought symptoms of stroke.

Nine in ten Atrial Fibrillation patients (89%) believe sudden trouble speaking is a symptom of someone experiencing a stroke.

Six in seven Atrial Fibrillation patients (86%) believe sudden numbness/ tingling/weakness/loss of movement in face/arm/leg, especially on one side of the body is a symptom of someone experiencing a stroke.

Four in five Atrial Fibrillation patients (81%) believe sudden problems with walking or balance is a symptom of someone experiencing a stroke.

Four in five Atrial Fibrillation patients (80%) believe sudden confusion or trouble understanding simple statements is a symptom of someone experiencing a stroke.


69

Potential Outcomes After Having A Stroke


16b. To the best of your knowledge, which, if any, of the following are possible outcomes after a stroke?

Chest pain

Sudden/unpredicted episodes of crying/laughing (pseudobulbar)

Sleep disorders

Impulse control

Pain

Seizures

Intimacy and sexual challenges

Inability to control urine or bowels (incontinence)

Fatigue

Tight/stiff muscles & inability to control muscles (spas-ticity)

Difficulty with swallowing (dysphagia)

Vision loss

Recurrent stroke

Weakness

Inability to drive

Death

Memory loss

Problems thinking (cognitive challenges)

Balance issues

Paralysis

Inability to speak (aphasia)

0 10 20 30 40 50 60 70 80 90 100

27

39

41

41

42

45

49

55

58

58

60

64

72

75

75

77

78

79

80

80

82

Total


Several potential negative outcomes are widely seen as possible after experiencing a stroke.

About four in five Atrial Fibrillation patients believe an inability to speak (82%), paralysis (80%), balance issues (80%), problems thinking (79%) and memory loss (78%) are possible outcomes after having a stroke.

More than three in four Atrial Fibrillation patients (77%) believe death is a possible outcome after having a stroke.


70




Stroke survivors see a far wider range of potential negative outcomes compared to Atrial Fibrillation-only patients.

Virtually every potential outcome after a stroke was cited by a significantly higher percentage of stroke survivors.

The largest gaps in perception were sleep disorders (59% survivors vs. 23% AFib-only patients), sudden/unpredicted episodes of crying/laughing (55% vs. 24%), fatigue (73% vs. 43%), pain (55% vs. 29%), inability to control urine or bowels (67% vs. 43%), and impulse control (52% vs. 30%).

Chest pain


Sleep disorders

Impulse control

Pain

Seizures



Fatigue

Tight/stiff muscles & inability to control muscles (spas-ticity)


Vision loss

Recurrent stroke

Weakness

Inability to drive

Death

Memory loss


Balance issues

Paralysis


0 10 20 30 40 50 60 70 80 90 100

34

55

59

52

55

53

56

67

73

66

67

73

79

79

80

79

82

83

85

78

81

20

24

23

30

29

36

43

43

43

50

52

56

65

70

70

75

73

75

75

81

83

Atrial Fibrilla-tion OnlyStroke Survivors



71

Atrial Fibrillation-Only Statement Agreement


17. How much do you agree or disagree with each of the following statements?

I think treating an irregular heartbeat is more important than preventing a blood clot

The cost of my medication is not a considera-tion if it reduces my risk of having an AFib-re-

lated stroke

I would like to have more information to take charge of my Atrial Fibrillation and learn

about reducing the risk of AFib-related stroke

Managing the irregular heart beat is most important to me

I will seek to find out everything I can about Atrial Fibrillation and reducing my AFib-re-

lated stroke risk

If a treatment that reduced my risk of AFib-re-lated stroke required regular visits to my

physician, I would do it

If a treatment reduces the risk of stroke caused by a blood clot in the brain, it would

not matter to me whether I had to take it once or twice in a day.

I would do whatever my physician tells me in order to reduce the risk of an AFib-related

stroke

0 10 20 30 40 50 60 70 80 90 100

51

77

80

85

87

92

92

93

Agree Strongly/ Somewhat

Base: Atrial Fibrillation Patients Only (n=248)

Virtually all Atrial Fibrillation-only patients would do whatever is needed to reduce their risk of AFib-related stroke, and most would like more information.

More than nine in ten AFib-only patients (92%) would do whatever their physician tells them in order to reduce the risk of an AFib-related stroke.

More than nine in ten AFib-only patients (92%) indicate it would not matter to them whether they had to take a treatment once or twice a day if it reduced the risk of stroked caused by a blood clot in the brain.

More than nine in ten AFib-only patients (92%) indicate that if a treatment that reduced their risk of AFib-related stroke required regular visits to their physician, they would do it (92%).

Four in five AFib-only patients (80%) would like to have more information to take charge of their Atrial Fibrillation and learn about reducing the risk of AFib-related stroke.


72

Atrial Fibrillation Fact Awareness (Previously Aware)


18. I will now read you a list of facts about Atrial Fibrillation. Please tell me whether you were previously aware or not previously of

these facts.

An alarming number of Atrial Fibrillation patients do not understand the severity of AFib-related strokes.

More than two in three Atrial Fibrillation patients (68%) were not previously aware that AFib-related strokes are nearly twice as likely to be fatal or disabling as non-AFib-related strokes.

Nearly two in three Atrial Fibrillation patients (64%) were previously aware that you can have 5 times greater risk for stroke if you are living with untreated Atrial Fibrillation.

Nearly three in five Atrial Fibrillation patients (58%) were previously aware that the majority of AFib-related strokes are caused by a blood clot in the brain.

Women with atrial fibrillation have a higher risk for ischemic stroke than

men

AFib-related strokes are nearly twice as likely to be fatal or disabling as

non-AFib-related strokes

The majority of AFib-related strokes are caused by a blood clot in the brain

You can have 5 times greater risk for stroke if you are living with untreated

Atrial Fibrillation

Some Atrial Fibrillation patients may not have any noticeable symptoms

People living with Atrial Fibrillation are at risk for stroke even if they only ex-perience occasional irregular heart-

beats

If I am in Atrial Fibrillation only some-times (intermittent), I may still be at risk

for AFib-related stroke

Physicians assess a patient's indi-vidual AFib-related stroke and bleed-ing risk when considering treatment

options for stroke risk reduction

By taking an oral anticoagulant (“blood thinner”), the risk of AFib-re-

lated stroke may be reduced by about two thirds

0 10 20 30 40 50 60 70 80

33

32

59

60

60

63

61

62

67

30

32

57

67

73

73

77

77

78

31

32

58

64

67

68

69

69

72

TotalAtrial Fibrillation OnlyStroke Survivors



73

Stroke Statement Agreement


19. How much do you agree or disagree with each of the following statements?

Having a stroke was my biggest fear

Since I experienced an AFib-related stroke, I sometimes feel like I'm a

burden to others

I felt I knew enough about reducing my risk of AFib-related stroke after

being diagnosed with Atrial Fibrilla-tion

There was not enough information on reducing the risk of AFib-related

stroke provided to me when I was ini-tially diagnosed with Atrial Fibrillation

Experiencing a stroke was worse than I had imagined

My life has not been the same since I experienced an AFib-related stroke

Experiencing an AFib-related stroke made me more focused on improving

my health

I wish I had known more about reduc-ing the risk of an AFib-related stroke

prior to experiencing a stroke

0 10 20 30 40 50 60 70 80 90 100

53

60

61

63

73

77

83

83



Stroke survivors underestimated the impact an AFib-related stroke could have on their lives.

Five in six stroke survivors (83%) wish they had known more about reducing the risk of an AFib-related stroke prior to experiencing a stroke.

More than three in four stroke survivors (77%) agree that their life has not been the same since experiencing an AFib-related stroke.

Nearly three in four survivors (73%) agree that experiencing a stroke was worse than they had imagined.

Three in five stroke survivors (60%) sometimes feel like they are a burden to others since experiencing an AFib-related stroke.

More than three in five stroke survivors (63%) believe that there was not enough information on reducing the risk of AFib-related stroke provided to them when they was initially diagnosed with Atrial Fibrillation.


74

Life Changes Experienced Since Stroke


20. You {mentioned/indicated} that your life has not been the same since experiencing an AFib-related stroke. In which, if any, of the

following ways has your life changed?

Had to change my living ar-rangements

Need assistance with daily ac-tivities

I am a burden on my family

Can no longer drive

Feel isolated

It has been a financial burden

Had to give up my job or reduce my hours

Can no longer do activities or hobbies that bring me joy

0 10 20 30 40 50 60 70 80 90 100

25

32

32

34

35

40

44

56

Base: Total Agree Life Has Changed Since Stroke (n=194)

Activities previously done outside of the home are most often affected post-stroke.

Among survivors who indicated their life has not been the same, more than one-half (56%) indicate they can no longer do activities or hobbies that bring them joy.

Among survivors who indicated their life has not been the same, more than two in five (44%) indicate they had to give up my job or reduce my hours.

Among survivors who indicated their life has not been the same, two in five (40%) indicate it has been a financial burden.


75


AFib StrokeTotal Only Survivor

Total Respondents (499) (248) (251)% % %

Gender

Male 49 50 49 Female 51 50 51

Mean Age: 62.1 60.9 63.2

Primary Coordinator For Daily Home/Medical Care

Self 83 96 70 Family member 15 4 26 Friend 1 - 2 Hired caregiver 1 0 2

Devices OwnMobile/cell phone 80 80 80 Desktop computer 72 74 70

Laptop or netbook computer

70 72 67

iPad or other tablet 46 49 44 E-reader 29 27 30

Devices Use To Access Health Information

Desktop computer 55 55 55

Laptop or netbook computer

51 53 49

iPad or other tablet 21 22 20 Mobile/cell phone 17 12 21 E-reader 4 1 7 None of the above 7 6 8

Marital StatusMarried 61 63 58 Not Married (net) 39 37 41

Patient Demographic Profile

AFib StrokeTotal Only Survivor

Total Respondents (499) (248) (251)% % %

Education

No College (net) 20 17 24 College (net) 79 83 75

Employment StatusEmployed (net) 27 33 21 Not Employed (net) 72 67 76

Median Household Income

57.8 63.7 51.1

Ethnic BackgroundCaucasian 86 88 85 African-American 6 5 8 Hispanic/Latino 2 2 2 Native American 2 2 2

Asian/Pacific Islander

1 2 1

Mixed ethnic background

1 0 1

Rather not answer 1 1 2

Type Of CommunityUrban 22 21 24 Suburban 58 61 55 Rural 19 18 21

Census RegionNortheast 21 21 21 South 38 35 41 Midwest 21 23 18 West 20 20 20


76

Detailed Findings: Caregivers



77

Type & Number of Strokes Experienced



E. What type of stroke did (he/she) experience?

F. In total, how many strokes has (he/she) experienced?

Ischemic strokes are the most common type experienced by survivors in the care of caregivers.

More than one in two caregivers (56%) indicate the person in their care has experienced an ischemic stroke.

One in five caregivers (20%) indicate the person in their care has experienced an hemorrhagic stroke.

One in five caregivers (19%) indicate the person in their care has experienced a Transient Ischemic Attack (TIA).

One in ten caregivers (10%) indicate the person in their care has experienced a combination of hemorrhagic and ischemic stroke.

More than one in two caregivers (55%) indicate the person in their care has experienced 1 stroke.

One in four caregivers (24%) indicate the person in their care has experienced 3 or more strokes.

Don't know

Combination of Hemorrhagic and

Ischemic

Transient Ischemic Attack or TIA

Hemorrhagic

Ischemic

0 10 20 30 40 50 60

10

10

19

20

56

1 stroke;

55%2

strokes; 21%

3 or more

strokes; 24%

Mean: 2


78

Time of Survivor’s Most Recent Stroke



G. How long ago did (his/her) most recent stroke take place?

Most caregivers are providing assistance to survivors who experienced a stroke less than 5 years ago.

Three in four caregivers (74%) are providing care to a survivor who experienced their most recent stroke less than 5 years ago.

One in five caregivers (20%) are providing care to a survivor who experienced their most recent stroke less than 1 year ago.

Less than 6 months ago; 10%

6 months to 11

months ago; 10%

1 to 2 years

ago; 32%

3 to 4 years

ago; 22%

5 or more years

ago; 26%

Mean: 3 years


79

Time And Activities Where Assistance Is Required



H. When it comes to everyday activities (such as bathing, dressing, or toileting), keeping in mind that (he/she) may need more

help in some areas, on average what percentage of the time do you have to provide assistance to (him/her)? I. For what type(s) of everyday activities do you need to provide assistance at least some of the time?

Caregiving covers all aspects of a survivor’s life, and a considerable percentage of caregivers are providing assistance for nearly all everyday activities.

On average, caregivers are providing assistance to survivors during 47% of their everyday activities.

One in seven caregivers (14%) provide assistance 100% of the time survivors are doing everyday activities.

One in two caregivers (50%) provide assistance at least half of the time survivors are doing everyday activities.

More than four in five caregivers who provide assistance (83%) drive for survivors at least some of the time.

Four in five caregivers who provide assistance (79%) help with shopping for survivors at least some of the time.

Three in five caregivers who provide assistance (62%) help with bathing for survivors at least some of the time.





100 per-cent; 14%

Base: Total Provide Assistance (n=190)

Housekeping/laundry/ preparing meals

Bill paying/money management

Feeding

Transferring

Toileting

Grooming

Dressing

Moving/mobility

Bathing

Taking medication

Shopping

Driving

0 10 20 30 40 50 60 70 80 90

3

3

33

39

40

54

58

62

62

76

79

83

Mean: 47%


80

Activities Survivor Experienced Difficulty With In First 6 Months Following Stroke


J. Did (he/she) experience difficulty or limitations with any of the following in the first six months OR as a result of (his/her) stroke?

Motor and cognitive limitations are most commonly observed by caregivers in the months immediately following a stroke.

More than nine in ten caregivers (92%) indicate the survivor in their care experienced one or more motor limitations within the first 6 months of suffering a stroke.

Four in five caregivers (81%) indicate the survivor in their care experienced one or more cognitive limitations within the first 6 months of suffering a stroke.

Impaired balance (71%), walking (70%), memory (70%), speech (60%), and arm movement (58%) are the most common limitations experienced as reported by caregivers.

TotalTotal Respondents (203)

% Experienced Limitations (net) 97

Motor (subnet) 92 Impaired balance 71 Walking 70 Speech 60 Arm movement 58 Hand movement 55 Leg movement 54

Cognition (subnet) 81 Memory 70 Maintaining attention 45 Calculation abilities 40

Affect (subnet) 69 Depression or sadness 56 Loss of appetite 33 Insomnia 30 Uncontrollable laughing or crying 19

Sensory (subnet) 62 Numbness 39 Pain 36 Tingling 32

Language (subnet) 59 Writing 52 Reading 44

Vision (subnet) 43 Impaired vision 37 Blindness 4 Other 3

Incontinence 39 Other 6

No limitations 3


81

Motor Limitations Patient Currently Experiences


Base: Total With Patients Who Have Experienced Motor Limitations (n=186)

K. You {mentioned/indicated} that (he/she) had experienced motor limitations as a result of (his/her) stroke. Which of the following limitations, if any, does (he/she) still experience?

Impaired balance and walking are the motor limitations most likely to remain over time.

Two in three caregivers (65%) whose survivor initially experienced motor limitations continues to suffer from impaired balance.

Nearly two in three caregivers (58%) whose survivor initially experienced motor limitations continues to suffer from walking limitations.

Only six percent of caregivers whose survivor initially experienced motor limitations indicated they no longer experience any type of motor limitation.

No longer experience any lim-itations

Speech

Arm movement

Leg movement

Hand movement

Walking

Impaired balance

0 10 20 30 40 50 60 70 80

6

42

47

47

48

58

65


82

Awareness of Patient’s Atrial Fibrillation Prior To Stroke And How Patient’s Life Has Changed



1a. Did you know that (he/she) had Atrial Fibrillation prior to (his/her) experiencing a stroke?

1b. To the best of your knowledge, how has (his/her) life changed, or what is (he/she) doing differently, since (he/she) was diagnosed with Atrial Fibrillation?

A slight majority of caregivers did not know the person currently in their care had Atrial Fibrillation prior to experiencing a stroke.

Less than one in two caregivers (47%) were aware the survivor in their care suffered from Atrial Fibrillation prior to experiencing a stroke.

More than two in five caregivers (43%) indicate the person in their care doesn’t go out as much since being diagnosed with Atrial Fibrillation.

Three in ten caregivers (29%) indicate the person in their care is getting healthier since being diagnosed with Atrial Fibrillation.

One in five caregivers (21%) indicate the person in their care is afraid to do exercise or other strenuous activity since being diagnosed with Atrial Fibrillation.

One in five caregivers (21%) indicate the person in their care is doing everything to learn about reducing risk of stroke due to Atrial Fibrillation since being diagnosed.

Knew about

pa-tient's Atrial

Fibrilla-tion

prior to stroke;

47%

Did not know about

pa-tient's Atrial

Fibrilla-tion un-til after

the stroke;

53%

He/she has not made any changes

Takes medication


Does everything to learn about Atrial Fibrillation

Does everything to learn about reducing risk of stroke due to

Atrial Fibrillation


Getting healthier – more exercise, eating right, etc.

Doesn't go out as much

0 10 20 30 40 50

27

3

8

10

21

21

29

43


83

Conditions Personally Thought Individual with Atrial Fibrillation Was At Increased Risk For Experiencing Prior to Patient’s Stroke



2. Prior to (his/her) experiencing a stroke, which, if any, of the following conditions did you personally think a person with Atrial Fibrillation would be at an increased risk for experiencing?

Prior to the person in their care experiencing a stroke, a slight majority of caregivers believed a person with Atrial Fibrillation was at an increased risk of stroke.

More than one-half of caregivers (54%) believed Atrial Fibrillation caused an increased risk of stroke prior to the person in their care experiencing a stroke.

Two in three caregivers (65%) believed Atrial Fibrillation caused an increased risk of irregular heartbeat prior to the person in their care experiencing a stroke.

Nearly one in two caregivers (47%) believed Atrial Fibrillation caused an increased risk of heart palpitations prior to the person in their care experiencing a stroke.

More than two in five caregivers (45%) believed Atrial Fibrillation caused an increased risk of heart attack prior to the person in their care experiencing a stroke.

None

Sleep apnea

Fainting

Chronic fatigue

Difficulty breathing/shortness of breath

High blood pressure

Heart attack

Heart palpitations

Stroke

Irregular heartbeat

0 10 20 30 40 50 60 70 80

22

21

24

29

33

36

45

47

54

65


84

Conditions Physician Indicated Patient At Increased Risk For Experiencing As Result Of Atrial Fibrillation



3. Prior to (his/her) experiencing a stroke, which, if any, of the following did (his/her) physician indicate (he/she) may be at an increased risk for experiencing as a result of Atrial Fibrillation?

A majority of caregivers do not believe a physician informed the person in their care of the increased risk of stroke with Atrial Fibrillation.

Two in five caregivers (39%) believe the person in their care was informed of an increased risk of stroke with Atrial Fibrillation.

One in three caregivers (34%) believe the person in their care was informed of an increased risk of irregular heartbeat with Atrial Fibrillation.

However, more than one in four caregivers (28%) don’t know what the survivor in their care was told by their physician.

None of the above

Don't know

Fainting

Sleep apnea

Chronic fatigue


Heart attack

Heart palpitations

High blood pressure

Irregular heartbeat

Stroke

0 10 20 30 40 50

19

28

8

8

10

19

23

26

27

34

39


85

Condition Concern Ratings (Very/Somewhat Concerned)



4a. Prior to (his/her) experiencing a stroke, how concerned was (he/she) in terms of experiencing any of the following as a result of Atrial Fibrillation?

4b. Prior to (his/her) experiencing a stroke, how concerned were you personally in terms of (him/her) experiencing any of the following as a result of Atrial Fibrillation?

Most caregivers do not believe Atrial Fibrillation-related stroke was a concern of the survivor in their care, and several conditions were of more widespread concern. Caregivers often believe they were more concerned.

One in three caregivers (34%) believe that prior to their stroke, the person in their care was concerned about stroke as a result of Atrial Fibrillation, compared to more than one-half of caregivers (56%) being concerned.

Two in five caregivers (40%) believe that prior to their stroke, the person in their care was concerned about irregular heartbeat as a result of Atrial Fibrillation, compared to three in five caregivers (60%) being concerned.

Nearly two in five caregivers (38%) believe that prior to their stroke, the person in their care was concerned about high blood pressure as a result of Atrial Fibrillation, compared to one-half caregivers (50%) being concerned.

Nearly two in five caregivers (38%) believe that prior to their stroke, the person in their care was concerned about heart palpitations as a result of Atrial Fibrillation, compared to one in two caregivers (52%) being concerned.

Sleep apnea

Fainting

Chronic fatigue


Heart attack

Stroke

Heart palpitations

High blood pressure

Irregular heartbeat

0 10 20 30 40 50 60 70

33

39

35

43

57

56

52

50

60

19

22

23

30

33

34

38

38

40

Patient

Caregiver


86

Ways Patient’s Life Has Changed Since Having A Stroke



4c. To the best of your knowledge, how has (his/her) life changed, or what is (he/she) doing differently, since having a stroke?

Caregivers observe a variety of negative life changes that occur with the survivor in their care.

More than three in five caregivers (62%) indicate the survivor in their care doesn’t go out as much since having a stroke.

One in two caregivers (51%) indicate the survivor in their care has experienced depression since having a stroke.

One in four caregivers (25%) indicate the survivor in their care is afraid to exercise or do strenuous activity since having a stroke.

However, one in three caregivers (33%) indicate the survivor in their care is getting healthier since having a stroke, and one in six (16%) indicate they do everything they can to learn about strokes..

He/she has not made any changes

Entire life has changed/loss of in-dependence


Does everything he/she can to learn about strokes

Afraid to exercise or do other stren-uous activity

Getting healthier – more exercise, eat-ing right, etc.

He/she has experienced depression


0 10 20 30 40 50 60 70

8

4

9

16

25

32

51

62


87






Caregivers are mostly familiar with several different types of stroke.

Three in four caregivers (76%) are very or somewhat familiar with ischemic stroke.

Two in five caregivers (39%) are very familiar with ischemic stroke.

More than seven in ten caregivers (72%) are very or somewhat familiar with hemorrhagic stroke.

Four in five caregivers (79%) are very or somewhat familiar with Transient Ischemic Attack (TIA).

0

10

20

30

40

50

60

70

80

90

100

39 34 41

37 38

38

14 18 13

10 9 8 Not at all familiarNot very familiarSomewhat familiarVery famil-iar

76 72 79


88

Stroke Type Identification



5d. To the best of your knowledge, which type of stroke occurs as a result of an obstruction (i.e., clot or blockage) within a blood vessel supplying blood to the brain?

5e. To the best of your knowledge, which type of stroke occurs as a result of a weakened blood vessel that ruptures and bleeds into the surrounding brain?

Caregivers are more likely to correctly identify a hemorrhagic stroke.

More than two in three caregivers (68%) correctly identified an ischemic stroke as being caused by an obstruction within a blood vessel supplying blood to the brain.

Four in five caregivers (80%) correctly identified a hemorrhagic stroke as being the result of a ruptured blood vessel that bleeds into the surrounding brain.

One in eight caregivers (12%) incorrectly identified a hemorrhagic stroke as being caused by an obstruction within a blood vessel supplying blood to the brain.

Don't know/not

sure


(TIA)

Hemorrhagic stroke

Ischemic stroke

0 20 40 60 80

13

6

12

68

Obstruction Within Blood Vessel Supplying Blood To The Brain

Don't know/not

sure


(TIA)

Ischemic stroke

Hemorrhagic stroke

0 20 40 60 80

11

3

5

80

Ruptured Blood Vessel That Bleeds Into Surrounding Brain


89

Stroke Type Believe Occurs Most Often In Atrial Fibrillation Patients and Prior Awareness of Different Stroke Types



5f. In AFib, which type of stroke do you think occurs more often? 5g. Prior to today, were you aware there were different types of strokes?

Half of caregivers believe ischemic strokes are most common in Atrial Fibrillation patients.

One in two caregivers (51%) believe ischemic stroke occurs most often in people diagnosed with Atrial Fibrillation.

Five percent of caregivers think hemorrhagic stroke occurs most often in people diagnosed with Atrial Fibrillation.

One in six caregivers (17%) think Transient Ischemic Attack (TIA) occurs most often in people diagnosed with Atrial Fibrillation.

More than one in four caregivers (27%) don’t know what type of stroke occurs most often in people diagnosed with Atrial Fibrillation.

Nearly nine in ten caregivers (86%) indicated they were aware there were different types of strokes.

Is-chemi

c stroke; 51%

Hemorrhagic stroke; 5%

Tran-sient

Is-chemic At-tack

(TIA); 17%

Don't know/

not sure; 27%

Previ-ously

aware; 86%

Not previ-ously

aware; 14%


90

Future Stroke Concern and Interest In Learning More About Reducing The Risk Of Stroke



6a. How concerned are you that (he/she) might experience an AFib-related Ischemic Stroke in the future? 6b. How interested would you be in learning more about how to reduce the risk of an AFib-related Ischemic Stroke?

6c. How concerned are you that (he/she) might experience a Hemorrhagic Stroke in the future? 6d. How interested would you be in learning more about how to reduce the risk of a Hemorrhagic Stroke?

6e. How concerned are you that (he/she) might experience an AFib-related Transient Ischemic Attack (a mini-stroke) in the future? 6f. How interested would you be in learning more about how to reduce the risk of an AFib-related Transient Ischemic Attack (a mini-stroke)?

There is near universal concern that survivors will experience additional strokes in the future.

Virtually all caregivers (96%) are very or somewhat concerned the survivor in their care will experience an ischemic stroke in the future.

Virtually all caregivers (95%) are very or somewhat concerned the survivor in their care will experience a Transient Ischemic Attack in the future.

Six in seven caregivers (86%) are very or somewhat concerned the survivor in their care will experience a hemorrhagic stroke in the future.

Virtually all caregivers (95%) are very or somewhat interested in learning more about how to reduce the reduce the risk of AFib-related ischemic stroke.

Hemorrhagic stroke

Transient Ischemic At-

tack

Ischemic stroke

70 80 90 100

86

95

96

Very/Somewhat Concerned Very/Somewhat Interested

Hemorrhagic stroke

Ischemic stroke


70 80 90 100

93

95

96


91

Patient’s Primary Concern About Having A Stroke



6g. What do you think concerns (him/her) most about having a stroke?

Loss of independence and physical function are believed to be the primary concerns about having a stroke.

One in three caregivers (33%) believe the loss of independence most concerns the survivor in their care about having a stroke.

Nearly one in five caregivers (18%) believe losing the ability to move, talk, or some other physical function most concerns the survivor in their care about having a stroke.

Nearly one in seven caregivers (13%) believe death most concerns the survivor in their care about having a stroke.

No answer

He/she is not concerned with having a stroke

Being unable to do his/her current job

Feelings of isolation

No longer being able to enjoy activities or hobbies

Financial burdens on him/her and his/her family

Being dependent on someone else

Death

Losing the ability to move, talk, or some other physical function

Loss of independence

0 10 20 30 40

2

7

2

3

4

7

9

13

18

33


92

Whether Physician Ever Discussed Increased Risk of Stroke Due To Atrial Fibrillation With Caregiver


Base: Total Not Told Of Increased Stroke Risk (n=124)

7b. Has (his/her) physician ever discussed with you the increased risk of stroke due to Atrial Fibrillation?

Caregivers typically discuss the increased risk of AFib-related stroke with physicians.

More than three in five caregivers (62%) have discussed the increased risk of stroke due to Atrial Fibrillation with the physician treating the person in their care.

Dis-cussed in-

creased risk; 62%

Not dis-

cussed in-

creased risk; 38%



93

Frequency Accompany Patient To Doctor’s Appointments



8a. How often do you typically go with (him/her) to (his/her) doctor’s appointments?

Virtually all caregivers are regularly going to doctor appointments.

Two in three caregivers (66%) always accompany the survivor in their care to doctor’s appointments.

Four in five caregivers (82%) accompany the survivor in their care to doctor’s appointments always or most of the time.

Only five percent of caregivers rarely or never accompany the survivor in their care to doctor’s appointments.

Always; 66%

Most of the time;

16%

Occa-sionally;

12%

Rarely; 3% Never; 2%


94

Atrial Fibrillation Stroke Treatment Conversation Initiation


Base: Total Attend Doctor’s Appointments Occasionally Or More Often (n=192)

8b. Thinking about conversations (he/she) has had with (his/her) physician about increased risk of AFib-related stroke and available

treatments to reduce the risk of AFib-related stroke, what percentage of the time would you say conversations are initiated by (him/her) versus those initiated by (his/her) physician?

Caregivers present at doctor’s appointments indicate that most conversations about AFib-related stroke and treatment options are initiated by the physician.

On average, caregivers indicated more than three in four (78%) conversations about treatments to reduce the risk of Atrial Fibrillation related stroke are initiated by the physician.

On average, caregivers indicated nearly one in four (23%) conversations about treatments to reduce the risk of Atrial Fibrillation related stroke are initiated by the physician.

Initi-ated by pa-

tient; 23%

Initi-ated by

physician; 78%


95

Ways Physician Has Discussed Specifics of Patient’s Atrial Fibrillation & Increased Risk Of Atrial Fibrillation-Related Stroke


8c. To the best of your knowledge, in which, if any, ways has (his/her) physician discussed the specifics of (his/her) atrial fibrillation

and increased risk of AFib-related stroke?

Most caregivers have seen physicians directly discuss AFib-related stroke with the survivors in their care, however not much else is done to further their education.

More than three in four caregivers who attend doctor visits (78%) indicate the survivor’s physician has directly discussed Atrial Fibrillation and the increased risk of stroke.

Nearly two in five caregivers who attend doctor visits (38%) indicate physicians have given written materials to read regarding Atrial Fibrillation or the increased risk of AFib-related stroke.

More than one in five caregivers who attend doctor visits (22%) indicate a nurse, educator, or other professional in the physician’s office has discussed their Atrial Fibrillation situation with the patient.

None/not discussed

Only prescribed medication

Directed patient to a pharmaceutical company's website that focused on the condition

Patient was directed to download an app for a mobile phone, tablet computer or other device

Directed to pharmaceutical company's website with information on medications to reduce risk of AFib-

related stroke

Patient was given educational CDs or DVDs

Directed patient to associations/websites related specifically to heart conditions/AFib-related stroke

A nurse/educator/other professional in office dis-cussed their Atrial Fibrillation situation with patient

Gave patient written material to read

Patient's physician discussed situation with patient directly

0 10 20 30 40 50 60 70 80

5

2

2

3

3

4

7

22

38

78

Base: Total Attend Doctor’s Appointments Occasionally Or More Often (n=192)


96

Whether Researched And Where Sought Information On Atrial Fibrillation-Related Strokes And/Or Atrial Fibrillation



9a. Have you personally ever researched or sought out information on AFib-related strokes and/or Atrial Fibrillation?

9b. Where specifically did you look for information on Atrial Fibrillation and/or AFib-related strokes?

Caregivers usually have conducted their own research on AFib-related strokes and/or Atrial Fibrillation, using a variety of sources to educate themselves.

Seven in ten caregivers (69%) have personally sought out information related to Atrial Fibrillation or AFib-related strokes.

Of caregivers who have researched Atrial Fibrillation, more than three in four (77%) obtained information from an association or website related specifically to heart conditions or AFib-related stroke.

Of caregivers who have researched Atrial Fibrillation, more than one in two (55%) have received information directly from the survivor’s physician.

Of caregivers who have researched Atrial Fibrillation, more than one in two (54%) looked at written materials.

Of caregivers who have researched Atrial Fibrillation, three in ten (29%) have received information from a nurse, educator, or other professional.

Re-searched

Atrial Fibrilla-tion-re-lated

strokes/Atrial

Fibrilla-tion; 69%

Not re-searched

Atrial Fibrilla-tion-re-lated

strokes/ Atrial

Fibrilla-tion; 31%

Educational CD or DVDs

On a social media website

On an app for a mobile phone, tablet computer or

other device

On a pharmaceutical company's website

From a nurse, educator, or other professional

From written materials

From patient's physician di-rectly

From an association/web-sites related specifically to

heart conditions/AFib-related stroke

0 10 20 30 40 50 60 70 80

5

8

11

13

29

54

55

77

Base: Total Have Researched (n=141)


97

Level Of Satisfaction With Information Provided By Physician


Base: Total Seeking Info on AFib Through Physician Directly (n=78)

9c. Overall, how satisfied were you with the information provided by (his/her) physician about (his/her) condition and increased risk

of AFib-related stroke?

Caregivers are generally satisfied with information provided by physicians.

Nearly one in two caregivers who received information from physicians (47%) were very satisfied with the information.

Six in seven caregivers who received information from physicians (87%) were very or somewhat satisfied with the information.

Very satis-fied; 47%

Somewhat satisfied;

40%

Not very satisfied;

9%

Not at all satisfied; 4%


98

Topics of Discussion Between Patient and Physician Regarding Atrial Fibrillation-Related Stroke


10. Has (his/her) physician ever discussed with (him/her) any of the following regarding AFib-related stroke?

Risks associated with and without treatment is the most common topic of conversation between caregivers and physicians.

Seven in ten caregivers who have discussed AFib-related stroke with the survivor’s doctor (71%) talked about the risk of having AFib-related stroke with and without medication.

One in two caregivers who have discussed AFib-related stroke with the survivor’s doctor (51%) talked about the symptoms of AFib-related stroke.

Nearly one in two caregivers who have discussed AFib-related stroke with the survivor’s doctor (47%) talked about actions to take if witnessing or experiencing symptoms of AFib-related stroke.

Nearly one in two caregivers who have discussed AFib-related stroke with the survivor’s doctor (47%) talked about the impact of AFib-related stroke on everyday life.

None of the above


Actions to take if witnessing or expe-riencing symptoms of AFib-related

stroke


His/her risk of having AFib-related stroke with and without medication

0 10 20 30 40 50 60 70 80

14

47

47

51

71

Base: Total Discussed Atrial Fibrillation-Related Stroke With Doctor (n=154)


99

Caregivers believe reduced risk and minimizing side effects are patients’ top priorities in treatment.

The most important Atrial Fibrillation treatment qualities to patients are that a treatment reduces the risk of a stroke caused by a blood clot in the brain (26%) and causes the least side effects (25%).

Being affordable is of lesser importance to patients, with only one-fifth of caregivers (20%) indicating it was the patient’s first or second most important treatment quality.

Patient’s Most Important Qualities In Treatment Designed To Reduce Risk Of Stroke From Atrial Fibrillation


11a. When discussing treatment options to reduce the risk of a stroke in atrial fibrillation with (his/her) doctor, which of the following is most important to (him/her)?

11b. And when discussing treatment options to reduce the risk of stroke in atrial fibrillation with (his/her) doctor, which of the following is second most important to (him/her)?

Don't know

No answer

Being affordable


Finding a treatment that is easy to use (e.g. once a day, etc.)

Using a treatment that causes the least side effects


- 10 20 30 40 50 60

1

3

9

13

19

25

26

2

4

11

16

21

23

23

3

6

20

29

40

48

49

Most 2nd Most Total



100

While equally important to patients, caregivers first and foremost place importance on reducing the risk of stroke.

Nearly one-half of caregivers who have discussed treatment options with the patient’s physician (46%) indicate the most important quality in treatment is reducing the risk of a stroke caused by a blood clot in the brain, and seven in ten (69%) place it within the top two most important qualities.

One in six caregivers who have discussed treatment options with the patient’s physician (17%) indicate the most important quality in treatment is using a treatment which causes the least side effects, and nearly one-half (46%) place it within the top two most important qualities.

Being affordable is not of primary importance to caregivers, with only eight percent indicating it was their first or second most important treatment quality.

Caregiver’s Most Important Qualities In Treatment Designed To Reduce Risk Of Stroke From Atrial Fibrillation


14a. When you are discussing treatment options to reduce the risk of stroke in atrial fibrillation with (his/her) doctor, which of the following is most important to you?

14b. And when you are discussing treatment options to reduce the risk of stroke in atrial fibrillation with (his/her) doctor, which of the following is second most important to you?

Don't know

No answer

Have not been included in conversations related to treatment options

Being affordable


Finding a treatment that is easy to use (once a day, etc.)

Using a treatment which causes the least side effects


- 10 20 30 40 50 60 70 80

1

2

2

4

14

13

17

46

1

2

2

4

18

21

29

23

2

3

3

8

32

34

46

69

Most 2nd Most Total

Base: Total Discussed Atrial Fibrillation-Related Stroke With Doctor (n=154)


101

Whether Patient Ever Taken Medications And Types Prescribed To Reduce Risk Of Atrial Fibrillation-Related Stroke


12a. Has (his/her) physician ever had (him/her) take medications to reduce the risk of AFib-related stroke?

12b. To the best of your knowledge, what type(s) of treatment options has (his/her) physician prescribed (him/her) in order to reduce the risk of AFib-related stroke?

Most caregivers indicate the person in their care has taken medication to reduce risk of AFib-related stroke.

More than nine in ten caregivers who have discussed Atrial Fibrillation-related stroke with a physician (92%) indicate that the physician has had the person in their care take medication to reduce their risk of AFib-related stroke.

Three in four caregivers who indicate the person in their care has taken medication to reduce their risk of AFib-related stroke (75%) indicate the survivor had been prescribed an oral anticoagulant.

Nearly two in five caregivers who indicate the person in their care has taken medication to reduce their risk of AFib-related stroke (38%) indicate the survivor had been prescribed an antiplatelet.

Taken medication; 92%

Not taken medication; 8%

No answer

Don't know

Antiplatelet

Oral anticoagulant

0 10 20 30 40 50 60 70 80

5

5

38

75

Base: Total Have Taken Medication (n=142)Base: Total Discussed Atrial Fibrillation-Related Stroke With Doctor (n=154)


102

Whether Patient Regularly Takes Prescribed Treatment


Base: Total Have Taken Medication (n=142)

12c. To the best of your knowledge, does (he/she) regularly take the treatment to reduce the risk of AFib-related stroke prescribed by

(his/her) doctor?

Caregivers predominantly indicate those in their care are compliant with the prescribed treatment.

Nine in ten caregivers of survivors who have been prescribed mediation (89%) indicate the patient regularly takes their prescribed treatment to reduce their risk of AFib-related stroke.

Seven percent of caregivers of survivors who have been prescribed mediation indicate the patient stopped taking their prescribed treatment to reduce their risk of AFib-related stroke.

Patient regularly takes prescribed treatment;

89%

Patient does not regularly take pre-scribed

treatment; 4%

Patient has stopped tak-ing prescribed treat-

ment; 7%


103

Topics of Discussion Between Caregiver and Physician Regarding Atrial Fibrillation-Related Stroke


13. Has (his/her) physician ever discussed with you directly any of the following regarding stroke?

A majority of caregivers who’ve discussed AFib with a physician covered the symptoms, impact, and actions to take.

Three in five caregivers who have discussed increased stroke risk with the patient’s physician (60%) have discussed the impact of AFib-related stroke on everyday life.

Three in five caregivers who have discussed increased stroke risk with the patient’s physician (59%) have discussed the symptoms of AFib-related stroke.

Nearly three in five caregivers who have discussed increased stroke risk with the patient’s physician (58%) have discussed the actions to take if witnessing symptoms of AFib-related stroke.

None of the above

Actions to take if witnessing symp-toms of AFib-related stroke



0 10 20 30 40 50 60 70 80

25

58

59

60



104

Gender Believe Has Higher Risk Of Atrial Fibrillation-Related Stroke & Whether Able To Describe Most Common Symptoms



15a. Who do you think has a higher risk of experiencing an AFib-related stroke? 15b. If asked, do you believe that you would be able to describe to someone the most common symptoms of a stroke?

Caregivers almost universally believe they can detect the most common stroke symptoms.

More than nine in ten caregivers (92%) feel they are able to describe the common symptoms of stroke.

Few caregivers know that women at are at higher risk of Atrial Fibrillation-related stroke.

Three in ten caregivers (30%) believe women have a higher risk of experiencing an AFib-related stroke.

One in four caregivers (25%) believe men have a higher risk of experiencing an AFib-related stroke.

Nearly one-half of caregivers (46%) do not believe either gender has a higher risk of experiencing an AFib-related stroke.

Men; 25%

Women; 30%

No dif-fer-

ence; 46%

Able to describe; 92%

Not able to describe; 8%


105

Symptoms Of Stroke


16a. To the best of your knowledge, which, if any, of the following are symptoms of someone experiencing a stroke?

Speaking and loss of movement are the most widely thought symptoms of stroke.

Virtually all caregivers (95%) believe sudden trouble speaking is a symptom of someone experiencing a stroke.

More than nine in ten caregivers (92%) believe sudden numbness/ tingling/weakness/loss of movement in face/arm/leg, especially on one side of the body is a symptom of someone experiencing a stroke.

Nearly nine in ten caregivers (88%) believe sudden problems with walking or balance is a symptom of someone experiencing a stroke.

Nearly nine in ten caregivers (88%) believe sudden confusion or trouble understanding simple statements is a symptom of someone experiencing a stroke.

More than three in four caregivers (77%) believe sudden vision changes is a symptom of someone experiencing a stroke.

Sudden chest pain

Sudden palpitations

Sudden shortness of breath

Sudden nausea

Sudden face and limb pain

Sudden dizziness

Sudden general weakness

A sudden, severe headache that is different from past headaches

Sudden vision changes

Sudden confusion or trouble understanding simple statements

Sudden problems with walking or balance

Sudden numbness/tingling/weakness/loss of movement in face/arm/leg, especially on only one side of body

Sudden trouble speaking

0 10 20 30 40 50 60 70 80 90 100

23

36

37

37

56

67

69

70

77

88

88

92

95



106




Most caregivers believe there are a wide range of negative outcomes after experiencing a stroke.

More than nine in ten caregivers believe paralysis (93%), an inability to speak (92%), memory loss (92%), and balance issues (92%) are possible outcomes after having a stroke.

Nine in ten caregivers (90%) believe death is a possible outcome after having a stroke.

Nearly nine in ten caregivers believe recurrent stroke (88%), weakness (88%), inability to drive (87%), and weakness (86%) are possible outcomes after having a stroke.

Chest pain


Seizures

Pain

Sleep disorders

Impulse control


Tight/stiff muscles and an inability to control (spastic-ity)


Fatigue


Vision loss


Weakness

Inability to drive

Recurrent stroke

Death

Balance issues

Memory loss


Paralysis

0 10 20 30 40 50 60 70 80 90 100

23 53 53 54 54 55 57

65 67

71 79 80 81

86 87 88 90 92 92 92 93



107

Aid Would Find Helpful In Providing Care To Patient


16c. Which of the following would you find useful in helping provide care?

Physical, tangible, and financial aid would all be viewed as helpful to caregivers.

Seven out of ten caregivers (70%) would find physical help useful in helping provide care.

More than three in five caregivers would find home modifications (63%), financial assistance (63%) and respite care (62%) useful in helping provide care.

Equipment

Respite care

Financial assistance

Home modifications

Physical help

0 10 20 30 40 50 60 70 80 90 100

56

62

63

63

70



108

Patient Atrial Fibrillation Statement Agreement


17. Thinking about the person who you care for, how much do you think (he/she) would have agreed or disagreed with each of the

following statements prior to experiencing a stroke?

Caregivers widely believe that prior to experiencing a stroke, the person in their care would have adhered to treatment and physician visits, regardless of cost. However, less agree that they learned all they could have about their condition.

Nine in ten caregivers (89%) believe the survivor in their care would agree that it would not matter if the treatment to reduce the risk of AFib-related stroke had to be taken once or twice a day.

Five in six caregivers (84%) believe the survivor in their care would agree that if a treatment that reduced risk of AFib-related stroke required regular visits to their physician, they would have done it.

One-half of caregivers (49%) feel their patient in their care would agree that they sought to find out everything they could about Atrial Fibrillation and AFib-related stroke risk.

Sought to find out everything he/she could about Atrial Fibrillation and reducing AFib-re-

lated stroke risk

Thought treating an irregular heartbeat was more important than preventing a blood clot

Would have liked more information to take charge of Atrial Fibrillation and learn about reducing the risk of an AFib-related stroke

Managing the irregular heart beat was most important

The cost of medication is not a consideration if it reduces his/her risk of having an AFib-re-

lated stroke

Would do whatever his/her physician tells him/her in order to reduce the risk of an AFib-

related stroke

If a treatment that reduced risk of AFib-re-lated stroke required regular visits to physician, he/she would have done it

If treatment reduces the risk of an AFib-re-lated stroke caused by a blood clot in the

brain, it would not matter whether they had to take it once or twice in a day

0 10 20 30 40 50 60 70 80 90 100

49

55

69

74

78

79

84

89




109

Caregiver Atrial Fibrillation Statement Agreement


17b. How much do you personally agree or disagree with each of the following statements regarding (his/her) Atrial Fibrillation prior

to experiencing an AFib-related stroke?

Caregivers would have near universally encouraged and had their loved ones adhere to treatment that would reduce the risk of AFib-related stroke. There is also regret in not having more information.

Virtually all caregivers (97%) would have encouraged their patient to follow a treatment if it required regular visits to their physician.

Nearly all caregivers (96%) believe the person in their care should do what the physician tells them to do in order to reduce the risk of AFib-related stroke.

Nine in ten caregivers (89%) would have liked to have had more information about Atrial Fibrillation and learned more about AFib-related stroke.

Cost is an important considera-tion in whether he/she will take

his/her medication

Treating an irregular heartbeat is more important than preventing a

blood clot

When he/she was initially diag-nosed with Atrial Fibrillation, I

tried to find out everything I could about it and reducing AFib-related

stroke risk

I would like to have had more in-formation to help him/her take

charge of his/her Atrial Fibrillation and learn about reducing the risk

of an AFib-related stroke

I believe he/she should do what his/her physician tells him/her in

order to reduce the risk of an AFib-related stroke

If a treatment required regular vis-its to the physician, I would have

encouraged him/her to do it

0 10 20 30 40 50 60 70 80 90 100

47

56

81

89

96

97




110

Caregiver Atrial Fibrillation Fact Awareness


18. I will now read you a list of facts about Atrial Fibrillation. Please tell me whether you were previously aware or not previously of

these facts.

There is little awareness of the impact of AFib-related strokes.

More than one in five caregivers (22%) are aware that AFib-related strokes are nearly twice as likely to be fatal or disabling as non-AFib-related strokes.

One in four caregivers (25%) are aware that women with Atrial Fibrillation have a higher risk of ischemic stroke than men.

Less than one-half of caregivers (44%) are aware that you can have 5 times greater risk for stroke if you are living with untreated Atrial Fibrillation.

AFib-related strokes are nearly twice as likely to be fatal or dis-

abling as non-AFib-related strokes

Women with Atrial Fibrillation have a higher risk for ischemic stroke

than men

You can have 5 times greater risk for stroke if you are living with un-

treated Atrial Fibrillation

The majority of AFib-related strokes are caused by a blood clot in the

brain

Physicians assess a patient's indi-vidual AFib-related stroke/bleeding risk when considering treatment op-

tions for stroke risk reduction

People living with Atrial Fibrillation are at risk for stroke even if they

only experience occasional irregu-lar heartbeats

If I am in Atrial Fibrillation only sometimes (intermittent), I may still

be at risk for stroke

By taking an oral anticoagulant (“blood thinner”), the risk of AFib-re-

lated stroke may be reduced by about two thirds

Some Atrial Fibrillation patients may not have any noticeable symptoms

0 10 20 30 40 50 60 70 80

22

25

44

51

52

53

55

56

61

Previously Aware



111

Patient Stroke Statement Agreement


19. Thinking about the person who you care for, how much do you think (he/she) would agree or disagree with each of the following

statements?

Caregivers believe the people in their care underestimated how bad experiencing a stroke could be to them.

Nearly nine in ten caregivers (88%) think the survivor in their care would agree that their life has not been the same since experiencing an AFib-related stroke.

Five in six caregivers (86%) believe the survivor in their care would agree that experiencing a stroke was worse than they had imagined.

Less than three in five caregivers (55%) believe the survivor in their care would agree that having a stroke was their biggest fear.

Three in four caregivers (74%) believe the survivor in their care would agree that there was not enough information on reducing the risk of AFib-related stroke provided to the caregiver when the survivor was initially diagnosed with Atrial Fibrillation.

Having a stroke was his/her biggest fear

He/she felt he/she knew enough about reducing my risk of AFib-re-lated stroke after being diagnosed

with Atrial Fibrillation

Experiencing an AFib-related stroke made him/her more focused on im-

proving his/her health

There was not enough information on reducing the risk of AFib-related stroke provided to me when he/she was initially diagnosed with Atrial

Fibrillation

He/she wishes he/she had known more about reducing the risk of an AFib-related stroke prior to expe-

riencing a stroke

Since he/she experienced an AFib-related stroke, he/she sometimes

feels like he/she is a burden to others

Experiencing a stroke was worse than he/she had imagined

His/her life has not been the same since he/she experienced an AFib-

related stroke

0 10 20 30 40 50 60 70 80 90 100

55

57

68

74

76

85

86

88




112

Caregiver Stroke Statement Agreement


19b. How much do you personally agree or disagree with each of the following statements?

While caregivers universally try to make the lives better of the survivors they care for, it requires more work than they thought and most would like more support and information.

Virtually all caregivers (98%) agree that since their patient experienced an AFib-related stroke, they have tried to have them focus on improving their health.

Nine in ten caregivers (91%) agree that their lives have not been the same since the person in their care experienced an AFib-related stroke.

Six in seven caregivers (86%) couldn’t have imagined the amount of work it takes to care for a stroke survivor.

Five in six caregivers (83%) wish they had more support and information to take care of the survivor in their care.

Four in five caregivers (81%) wish they had more information on Atrial Fibrillation and Stroke.

I was not aware of the risk of stroke in Atrial Fibrillation

I wish I had more information on Atrial Fibrillation and Stroke

I wish I had more support and in-formation to take care of him/her after having experienced an AFib-

related stroke

I couldn't have imagined the amount of work it takes to care for

a stroke survivor

My life has not been the same since he/she experienced an AFib-

related stroke

Having an AFib-related stroke has changed him/her in many unex-pected ways (physically, emo-

tionally, mentally, etc.)

Since he/she experienced an AFib-related stroke, I have tried to have him/her focus on improving

his/her health

0 10 20 30 40 50 60 70 80 90 100

70

81

83

86

91

91

98




113

Patient’s Life Changes Since Stroke


20. You had earlier mentioned that (his/her) life has not been the same since experiencing an AFib-related stroke. In which, if any, of

the following ways has (his/her) life changed?

Caregivers see a physical and emotional toll taken on the lives of survivors.

Three in four caregivers (75%) indicate the survivor in their care can no longer drive and needs assistance with daily activities.

Nearly three in four caregivers (73%) indicate the survivor in their care feels like they are a burden on their family.

Two in three caregivers (65%) indicate the survivor in their care feels isolated.

He/she had to give up his/her job or reduce his/her hours

It has been a financial burden on him/her

He/she had to change his/her living arrangements

He/she feels isolated

He/she can no longer do activi-ties or hobbies that bring him/

her joy

He/she feels he/she is a burden on his/her family

He/she needs assistance with daily activities

He/she can no longer drive

0 10 20 30 40 50 60 70 80 90 100

34

46

49

65

72

73

75

75

Base: Total Agree Patient’s Life Has Changed (n=179)


114

Ways Caregiver’s Life Has Changed Since Patient’s Stroke


20b. In which, if any, of the following ways has your life changed since becoming a caregiver to a stroke survivor?

A majority of caregivers feel overwhelmed and have less time for themselves, and many have a different relationship with the survivor.

More than nine in ten caregivers (92%) feel they have a lot more responsibilities since becoming a caregiver.

Two in three caregivers (66%) don’t have as much time to do activities or hobbies that bring them joy.

Three in five caregivers (60%) feel like they have more to do than they can handle.

Nearly three in five caregivers (56%) feel more socially isolated.

More than two in three caregivers (68%) feel their relationship is different with their patient since they suffered a stroke.

None of the above

Fight more with him/her

Had to give up my job or reduce my hours

I've had to change my living ar-rangements

My financial situation is not as strong

Feel more socially isolated

Feel like I have more to do than I can handle

Don't have as much time to do activities or hobbies that bring

me joy

Our relationship is different than it used to be

Have a lot more responsibili-ties

0 10 20 30 40 50 60 70 80 90 100

1

31

33

34

50

56

60

66

68

92



115



%

Caregiver GenderMale 16 Female 84

Mean Age 58.6

Patient GenderMale 57 Female 43

Relationship To PatientYour spouse 44 A family member 44 A friend 4 Paid caregiver 4

Devices OwnDesktop computer 66 Laptop or netbook computer 81 Mobile/cell phone 86 iPad or other tablet 56 E-reader 29

Devices Use To Access Health Information

Desktop computer 52 Laptop or netbook computer 61 Mobile/cell phone 29 iPad or other tablet 38 E-reader 4 None of the above 1

Caregiver Demographic Profile


%

Marital StatusMarried 75 Not Married (net) 24

EducationNo College (net) 12 College (net) 87

Employment StatusEmployed (net) 38 Not Employed (net) 61

Median Household Income $60.7

Ethnic BackgroundAfrican-American 4 Asian/Pacific Islander 3 Caucasian 88 Hispanic/Latino 2 Mixed ethnic background 1

Type Of CommunityUrban 17 Suburban 55 Rural 28

Census RegionNortheast 25 South 33 Midwest 26 West 17

Date post:	22-Dec-2015
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