Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation (GRASP-AF)

The GRASP-AF tool was initially developed by the West Yorkshire Cardiovascular Network, the Leeds Arrhythmia team and PRIMIS+, as part of the NHS Improvement AF in primary care national priority projects. NHS Improvement is currently supporting the national roll out of the tool, and is leading the revision and further development of the tool.

NHS Improvement is promoting the use of this tool, as part of a systematic approach to the identification, diagnosis and optimal management of patients with AF to reduce their risk of stroke.

GRASP-AF

• Provides a set of MIQUEST queries to identify patients with a diagnosis of AF
• The GRASP - AF tool calculates their stroke risk using the validated CHADS2 scoring system
• The tool highlights patients with a CHADS2 score of 2 or more not receiving warfarin who would benefit from review to assess the appropriateness of anti-coagulation
• The tool does not assess contraindications to warfarin, the decision whether or not to start warfarin remains a clinical one

"Treating these patients with Warfarin could prevent 6,000 stokes nationally and save 4,000 lives each year” (Nice 2006)

To access the GRASP-AF tool, click HERE, where you can download the GRASP-AF library and access supporting guidance.

After running the GRASP-AF tool, we recommend the data is uploaded to CHART-Online which will allow acess to CHART Online, a web based, comparative tool which will allow the comparison of data for benchmarking.

The tool should be re run as part of an audit cycle to optimise the management of AF to reduce the risk of stroke.

Please use the links on the right for more information.