Authors: Kimberly Hayden, William Schweinle

PMID: 25906500

ISSN: 0038-3317

Journal Title: South Dakota medicine : the journal of the South Dakota State Medical Association

Publication Date: 2015 Mar



Prevalence of atrial fibrillation (AF) continues to rise in an aging population. New strategies in anticoagulation management for the prevention of stroke are expanding options for individualized, patient centered care.


Demographic information was collected on 477 AF patients undergoing international normalized ratio testing for anticoagulation therapy. Travel distances and times were calculated based on patient address and testing site.


Of the 477 patients studied, 60 percent were male. The average age was 76 years with a median age of 77.5 years. The average one-way distance traveled was 11.8 miles and 16 minutes, 45 seconds. Half of the patients were traveling at least six miles and 11 minutes. Ten percent of patients traveled at least 30 miles and could be classified as rural.


Rural patients should be recognized and considered for alternative anticoagulation medications or individualized approaches to INR monitoring. They often encounter socioeconomic barriers to care and other health risks associated with rural travel. Providers need to consider basic demographic information when formulating treatment plans in conjunction with their patients to achieve effective patient centered care.

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