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...
| Autores: | , , , , , |
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| 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 |
| 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. |
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