Although ORBIT is the best tool for this purpose, other bleeding risk tools may need to be used until it is embedded in clinical pathways and electronic systems. [2021] 1.2.3 Offer monitoring and support to modify risk factors for bleeding, including: uncontrolled hypertension (see NICE's guideline on hypertension in adults) poor control of international normalised ratio (INR) in patients on vitamin K antagonists concurrent medication, including antiplatelets, selective serotonin reuptake inhibitors (SSRIs) and non-steroidal anti-inflammatory drugs (NSAIDs) harmful alcohol consumption (see NICE's guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence) reversible causes of anaemia. [2021] Discussing the results of the risk assessment 1.2.4 Discuss the results of the assessments of stroke and bleeding risk with the person taking into account their specific characteristics, for example comorbidities, and their individual preferences. For further guidance, see the section on enabling patients to actively participate in their care in NICE's guideline on patient experience in adult NHS services. [2021] For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on bleeding risk. Full details of the evidence and the committee's discussion are in evidence review E and F: risk stratification tools for predicting bleeding in people with atrial fibrillation. 