In recent clinical guidance from NICE (2014), oral anticoagulants (warfarin or DOACs) were recommended as first line treatment for patients with AF and at increased risk of stroke. Evidence now indicates that patients with AF should not be offered aspirin as a monotherapy for stroke prevention as it is a barrier to appropriate stroke prevention with oral anticoagulation.

There are also instances when patients should have their anticoagulation therapy re-assessed. NICE recommends a review of warfarin anticoagulation in the following circumstances:

Patients should be considered for a DOAC if appropriate, but should have their anticoagulation therapy re-assessed if they are nonadherent.