In Geriatricare we can read that eleven scientific medical societies require the free prescription of direct action oral anticoagulants (ACT). Alternative to syntrone to prevent stroke and other thromboembolic events in patients with Atrial Fibrillation. I was recently asked to start this treatment and was refused a visa by the Osakidetza Medical Inspectorate. In fact, it follows a state approach, expressed in the Therapeutic Conduct Report (PPT), totally obsolete and contrary to European and international evidence and recommendations (WHO).

It is indifferent that the use of NRC is of great benefit to patients, and that in Europe it is the first option to prevent stroke. It is indifferent that more than half of the patients with Sintrom are poorly anticoagulated and have a higher risk of thrombotic, hemorrhagic, mortality and health expenditure phenomena.

In these times of lack of nursing staff, it seems absurd to maintain in their health centers so many controls and not to improve prevention in Sintron. In Cantabria, NRC is used directly without a visa requirement. Upgrade!

Iñigo Jaca Arrizabalaga, physician.