The use and adherence of oral anticoagulants in Primary Health Care in Catalunya, Spain

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 Insti...

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Detalles Bibliográficos
Autores: Giner-Soriano, Maria|||0000-0003-3750-9233, Cortés, Jordi|||0000-0002-3764-0795, Gomez-Lumbreras, Ainhoa|||0000-0002-3916-0402, Prat Vallverdú, Oriol, Quijada-Manuitt, María Ángeles|||0000-0002-9624-0177, Morros, Rosa|||0000-0001-6752-8748
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:232716
Acceso en línea:https://ddd.uab.cat/record/232716
https://dx.doi.org/urn:doi:10.1016/j.aprim.2020.05.016
Access Level:acceso abierto
Palabra clave:Atrial fibrillation
Oral anticoagulants
Adherence
Persistence
Electronic health records
Fibrilación auricular
Tratamiento anticoagulante oral
Adherencia
Persistencia
Registros electrónicos de salud
Descripción
Sumario: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. Data source: 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.