Patient education is essential to provide patients with suf cient information to enable them to make an informed decision about whether they wish to take OAC, and if they do, which OAC they would prefer.203,476,482 Education needs to be tailored to the person s desire for information and their level of health literacy to promote patient understanding. Recently, a prospective survey of 499 AF patients (with and without previous stroke) in the United States found that most (87%) desired more information about AF and how to reduce their risk of AF- AF patients perceive greater satisfaction with treatment if they are engaged in treatment decisions and provided with relevant information (verbal, visual, written, electronic/on-line resources, as appropriate, chosen by the patient), which is well communicated by their health-care providers,467,473,483 and updated over time. Full details on shared decision-making, patient preferences, and patient education/counseling are provided in e-Tables 24-26. Recommendations 60. In AF patients who have previously refused OAC, we suggest reinforcing educational messages at each contact with the patient and revisit OAC treatment decisions (Ungraded consensus-based statement). Remark: Patient and physician treatment objectives often differ signi cantly and it is important to elicit from the patient what outcomes of OAC treatment are important to them. Remark: Explain the risk of stroke and bene t/risks of treatment in terms the patient can understand and signpost the patient to appropriate educational resources Acknowledgments Financial/non nancial disclosure: See e-Table 1 for complete list of con icts of interest. Endorsements: This guideline has been endorsed by the AF Association, American College of Clinical Pharmacy (ACCP), Arrhythmia Alliance, and StopA b.org. 