American College of Physicians awarded grant to develop program to help patients recognize warning signs, prevent stroke

Stroke is a leading cause of death in the United States

Philadelphia, September 22, 2014 -- The American College of Physicians (ACP) announced today that it will develop a program to help patients recognize the signs and symptoms of nonvalvular atrial fibrillation (NVAF), a common type of arrhythmia or abnormal heart rhythm that is associated with an approximately five-fold increase in the risk of embolic stroke.1 ACP received a $212,000 grant sponsorship in support of the program, "Stopping Stroke Through Engaged Patients" (STEP), from the Bristol-Myers Squibb and Pfizer alliance.

"STEP will be a comprehensive patient engagement program with print, video, and online resources," said David Fleming, MD, FACP, president, ACP. "Sharing of knowledge, effective communication, and shared decision making between patients and physicians are critical components to medication adherence and lifestyle modification, which are two important factors in reducing the risk of stroke."

The prevalence of NVAF is expected to climb given the aging U.S. population, reaching 12.1 million cases in 2030.2

Under an advisory committee of clinical experts and patient advocate representatives with support from ACP's Center for Patient Partnership in Healthcare (CPPH), the STEP program will develop a comprehensive toolkit that includes a self-management guidebook, worksheets to engage and empower patients, and a video.

The STEP program will incorporate health literacy best practices such as utilization of plain language, breaking complex information into smaller understandable chunks, and limiting the number of messages.3

"These various communication modes will appeal to different types of adult learners, including those who prefer visual aids, hearing verbal instructions, or using hands-on tools," said Wendy Nickel, MPH, director, CPPH.

The guidebook will focus on self-management, goal-setting, and taking steps to control NVAF and reduce stroke risk. Like other ACP patient self-management materials, the guidebook will feature real patients telling their stories, with photos and content that resonate with the adult population at risk for stroke from NVAF. The guide will be written in commonly used vocabulary and every-day terms in English and Spanish so that it can be easily understood by patients and families.

Perforated worksheets inside the guidebook will empower patients to stay in control of their NVAF and reduce their risk of stroke through proper medication adherence. Lack of adherence is estimated to cause approximately 125,000 deaths, an increase in hospitalizations, and a substantial increase in morbidity and mortality.4

The video will show how an actual patient was empowered to reduce the risk of stroke, partnered with the health care team to develop a treatment plan through shared decision making, and managed anticoagulation therapy and other medicines.

1. Wolf, P.A., Abbott, R.D., & Kannel, W. B. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke, 983-988.

2. Liu, X. Estimates of Current and Future Incidence and Prevalence of Atrial Fibrillation in the U.S. Adult Population. The American Journal of Cardiology, 1142-1147.

3. How to Write Easy-to-Read Health Materials: MedlinePlus. (2013, February 1). U.S. National Library of Medicine. Retrieved May 12, 2014, from

4. Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, et al. Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review. Ann Intern Med. 2012;157:785-795.

About the American College of Physicians
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.