Cholinga
Cholinga chake chinali kuyambitsa bwino komanso mosamala gulu latsopano la anticoagulants (Zithunzi za NOAC) pofuna kupewa sitiroko (cerebral infarction) kwa odwala omwe ali ndi vuto la atrial fibrillation (mtundu wa arrhythmia womwe mtima umagunda mosakhazikika ndipo nthawi zambiri umathamanga), kotero kuti kusatsimikizika pachitetezo cha kugwiritsiridwa ntchito kwa zinthu izi tsiku ndi tsiku kuchotsedwe. Panafunikanso kufufuza kutsika mtengo kwa othandizirawa poyerekeza ndi mankhwala 'omwe alipo' a anticoagulant ku Netherlands pogwiritsa ntchito zida za vitamini K zomwe zimayenderana ndi INR pogwiritsa ntchito chithandizo cha thrombosis..
Njira
Pa nthawi ya kukhazikitsidwa kwa NOACs pofuna kupewa sitiroko kwa odwala omwe alibe valvular atrial fibrillation. (Mtengo wa NVAF) ku Netherlands kumapeto 2012 Pempho la Unduna wa Zaumoyo, upangiri udapangidwa ndi upangiri pakukhazikitsa pang'onopang'ono komanso kotetezeka kwa NOACs.. Zifukwa zazikulu za izi zinali bungwe labwino la chisamaliro cha thrombosis m'dziko lathu poyerekeza ndi mayiko ena akumadzulo komanso mtengo wokwera wa chithandizo ndi NOAC.. Malangizowa adapangidwa ndi oimira mabungwe asayansi omwe akukhudzidwa mwachindunji (Mtengo wa NVVC, NIV, Mtengo wa NVN, NOV, VAL/NVKC, NVZA/KNMP). Kufunika kotsatira chitsogozo ndikuwonetsetsa kuyambika kosamalitsa kunagogomezedwa ndi bungwe la Dutch Cardiology Association panthawiyo.. analinso, pa pempho la boma, bungwe lofufuza lakhazikitsidwa kuti lizichita kafukufuku wofunsidwa pachitetezo komanso kutsika mtengo kwa othandizirawa pazochitika zatsiku ndi tsiku.. Kuti izi zitheke, kafukufuku woyesa adachitika poyambira ndi nkhokwe ya VEKTIS (zambiri za inshuwaransi), momwe odwala amachitira ndi oral anticoagulation kwa chizindikiro cha NVAF adadziwika. Deta ya inshuwaransi iyi idakhala yosakwanira (wodwala)ali ndi chidziwitso kuti athe kuyankha mafunso omwe afunsidwa. Kafukufuku watsopano adakonzedwa kuti asonkhanitse zambiri zokhudzana ndi odwala kuchokera ku zochitika za tsiku ndi tsiku. theka la February 2016 ndiye ndondomeko yotsimikizika ku ZonMw ya 'kulembetsa dziko lonse la anticoagulation kwa NVAF': Dutch AF Registry' ndipo ntchito yayikuluyi ikuyembekezeka kuyamba chaka chino.
Chotsatira
Mosiyana ndi mawu oyamba, kulembedwa kwa chitsogozo ndi kafukufuku wowonjezera zitha kuperekedwa, zokhudzana ndi chikhalidwe cha Dutch. Kukayikakayika ndi kukambitsirana kumeneku kunayambitsa anthu ambiri (zina zosafunikira komanso zosamveka) kulengeza koyipa kozungulira ma NOAC ndi zokambirana pakati pa akatswiri (akatswiri amtima, ophunzira, akatswiri a minyewa, akatswiri onse ndi thrombosis utumiki). Zinapangitsa kuti msika uyambe pang'onopang'ono kuposa momwe timayembekezera, kumene osati opanga ma NOAC okha komanso mayanjano odwala omwe sanakhutire: Ali kuti wodwalayo m'nkhaniyi?
Maphunziro
Maphwando ambiri adatenga nawo gawo pakukhazikitsa ma NOAC, mwina ndi zokonda zosemphana. Chidwi cha wodwalayo chinazimiririka pang'onopang'ono m'dera lovutali, pamene izi zikanayenera kupanga maziko opitilira kufotokozera mosamala pansi pa udindo wamagulu osiyanasiyana. Izi zikadapangitsa kuti chipwirikiticho chikhale chochepa ndipo zikadayankha mafunso okhudzana ndi chitetezo komanso kutsika mtengo kwa ma NOAC posachedwa., zokhudzana ndi chikhalidwe cha Dutch. Hans van Laarhoven (woimira bungwe la odwala Hart&Gulu la migolo) anatero mokongola: "Izi zitha kutsutsana ndi njira yophunzitsira anthu."
