Dual antithrombotic therapy and gastroprotection in atrial fibrillation: an observational primary care study

The authors do state that individual notes were not accessed for this study but having been a Cardiology GPSI and now working as a locum, I find that one problem is information flow downwards from the hospital sector especially informing 'patients' about duration of therapy. This is compounded by the way the whole NHS is so rushed that if someone on an antiplatelet is seen in A&E with new AF, they may be started on anticoagulants without anyone joining the dots and stopping the aspirin. The ESC has been clear for some time about the risks and the protocols, but I am not sure this percolates downwards. Can the authors also comment what their views are (and the evidence, if there) of the need for PPI for those on anticoagulants alone as we increasingly realise that PPI are not risk-free drugs.