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Title: | Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study) |
Author: | Dalmau Llorca, Maria Rosa Aguilar Martín, Carina Carrasco Querol, Noèlia Hernández Rojas, Zojaina Forcadell Drago, Emma Rodríguez Cumplido, Dolores Pepió i Vilaubí, Josep M. Castro Blanco, Elisabet Gonçalves, Alessandra Queiroga Fernández Sáez, José |
Keywords: | Fibril·lació auricular Anticoagulants (Medicina) Atrial fibrillation Anticoagulants (Medicine) |
Issue Date: | 24-Feb-2021 |
Publisher: | MDPI |
Abstract: | Background: Oral anticoagulants (OAs) are the treatment to prevent stroke in atrial fibrillation (AF). Anticoagulant treatment choice in non-valvular atrial fibrillation (NVAF) must be individualized, taking current guidelines into account. Adequacy of anticoagulant therapy under the current criteria for NVAF in real-world primary care is presented. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in Primary Care (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centers in 2018. Results: In total, 41,430 (68%) were treated with vitamin K antagonists (VKAs) and 19,548 (32%) NVAF with direct-acting oral anticoagulants (DOACs). Inadequate prescription was estimated to be 36.0% and 67.6%, respectively. Most DOAC inadequacy (77.3%) was due to it being prescribed as a first-line anticoagulant when there was no history of thromboembolic events or intracranial hemorrhage (ICH). A total of 22.1% had missing estimated glomerular filtration rate (eGFR) values. Common causes of inadequate VKA prescription were poor control of time in therapeutic range (TTR) (98.8%) and ICH (2.2%). Conclusions: Poor adequacy to current criteria was observed, being inadequacy higher in DOACs than in VKAs. TTR and GFR should be routinely calculated in electronic health records (EHR) to facilitate decision-making and patient safety. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/ijerph18052244 |
It is part of: | International Journal of Environmental Research and Public Health, 2021, vol. 18, num. 5 |
URI: | http://hdl.handle.net/2445/175799 |
Related resource: | https://doi.org/10.3390/ijerph18052244 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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ijerph-18-02244-v2.pdf | 724.57 kB | Adobe PDF | View/Open |
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