descriptionPublicationkeyboard_double_arrow_right Article , Other literature type 01 Oct 2020 Spanish Publisher:Elsevier BVJournal:Atención Primaria, volume 52, pages 529-538 (issn: 0212-6567,

Authors: Maria Giner-Soriano; Jordi Cortes; Ainhoa Gomez-Lumbreras; Oriol Prat-Vallverdú; Mª Angeles Quijada-Manuitt; Rosa Morros;

doi: 10.1016/j.aprim.2020.05.016

pmid: 32788057

pmc: PMC7505898

handle: 11351/5184 , 2117/330462 , 2445/174470

The use and adherence of oral anticoagulants in Primary Health Care in Catalunya, Spain: A real-world data cohort study

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Abstract

We aimed to describe sociodemographic, comorbidities, co-medication and risk of thromboembolic events and bleeding in patients with NVAF initiating oral anticoagulants (OAC) for stroke prevention, and to estimate adherence and persistence to OAC.Primary Health Care (PHC) in the Catalan Health Institute (ICS), Catalunya, Spain.All NVAF adult patients initiating OAC for stroke prevention in August 2013-December 2015.Population-based cohort study. Persistence was measured in patients initiating OAC in August 2013-December 2014.SIDIAP, which captures electronic health records from PHC in the (ICS), covering approximately 5.8 million people.51,690 NVAF patients initiated OAC; 47,197 (91.3%) were naive to OAC and 32,404 (62.7%) initiated acenocoumarol. Mean age was 72.8 years (SD 12.3) and 49.4% were women. Platelet-aggregation inhibitors were taken by 9105 (17.6%) of the patients. Persistence and adherence were estimated up to the end of follow-up. For 22,075 patients, persistence was higher among the non-naive patients [n=258 (61.7%)] than among the naive [n=11,502 (53.1%)]. Adherence was estimated for patients initiating DOAC and it was similar in naive and non-naive patients. Among the naive to DOAC treatment, those starting rivaroxaban showed a highest proportion [(n=360 (80.1%)] of good adherence at implementation (MPR>80%) while patients starting dabigatran were less adherent [n=203 (47.8%)].Acenocoumarol was the most frequently prescribed OAC as first therapy in NVAF patients. Non-naive to DOAC showed better persistence than naive. Rivaroxaban showed higher proportion of adherent patients during the implementation phase than apixaban and dabigatran the lowest.

Related Organizations

Universitat Politècnica de Catalunya
Spain
Universitat Polite`cnica de Catalunya
Spain
Departament de Salut
Spain
Government of Catalonia
Spain
Universitat Polit?cnica de Catalunya
Spain

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Keywords

Àrees temàtiques de la UPC::Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària, Medicine (General), :Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Anticoagulants [CHEMICALS AND DRUGS], :Matemàtiques i estadística::Matemàtica aplicada a les ciències [Àrees temàtiques de la UPC], Administration, Oral, adherencia, :Other subheadings::Other subheadings::/drug therapy [Other subheadings], Fibrilación auricular, Cohort Studies, sample surveys, DISCIPLINES AND OCCUPATIONS::Natural Science Disciplines::Biological Science Disciplines::Pharmacology::Pharmacoepidemiology, Atrial Fibrillation, Electronic health records, DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation, :disciplinas de las ciencias naturales::disciplinas de las ciencias biológicas::farmacología::farmacoepidemiología [DISCIPLINAS Y OCUPACIONES], :Otros calificadores::Otros calificadores::/tratamiento farmacológico [Otros calificadores], Other subheadings::Other subheadings::Other subheadings::/drug therapy, registros electrónicos de salud., :enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial [ENFERMEDADES], Registros electrónicos de salud, Primary care, Stroke, :Natural Science Disciplines::Biological Science Disciplines::Pharmacology::Pharmacoepidemiology [DISCIPLINES AND OCCUPATIONS], Classificació AMS::92 Biology and other natural sciences::92D Genetics and population dynamics, Persistencia, Original Article, Female, DISCIPLINAS Y OCUPACIONES::disciplinas de las ciencias naturales::disciplinas de las ciencias biológicas::farmacología::farmacoepidemiología, Adult, Biomatemàtica, Catalonia, Classificació AMS::62 Statistics::62D05 Sampling theory, sample surveys, Otros calificadores::Otros calificadores::Otros calificadores::/tratamiento farmacológico, :92 Biology and other natural sciences::92D Genetics and population dynamics [Classificació AMS], :62 Statistics::62D05 Sampling theory, sample surveys [Classificació AMS], Fibril·lació auricular - Tractament - Catalunya, Persistence, R5-920, persistencia, Classificació AMS::62 Statistics::62D05 Sampling theory, Tratamiento anticoagulante oral, Cataluña, COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos hematológicos::anticoagulantes, registros electrónicos de salud, Fibril·lació auricular, CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Anticoagulants, Humans, ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial, Sampling (Statistics), Assistència primària, tratamiento anticoagulante oral, Aged, Retrospective Studies, Biomathematics, :Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària [Àrees temàtiques de la UPC], Primary Health Care, Anticoagulants, Atrial fibrillation, :acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos hematológicos::anticoagulantes [COMPUESTOS QUÍMICOS Y DROGAS], Àrees temàtiques de la UPC::Matemàtiques i estadística::Matemàtica aplicada a les ciències, Adherence, Spain, Anticoagulants (Medicina), Oral anticoagulant, Anticoagulants (Medicine), Mostreig (Estadística), :Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation [DISEASES], Adherencia, Farmacoepidemiologia

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