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The Tasmanian Atrial Fibrillation Study: Transition to Direct Oral Anticoagulants 2011-2015

Admassie, E, Chalmers, L and Bereznicki, LR ORCID: 0000-0003-3974-3437 2017 , 'The Tasmanian Atrial Fibrillation Study: Transition to Direct Oral Anticoagulants 2011-2015' , Cardiovascular Therapeutics, vol. 35, no. 3 , pp. 1-8 , doi: 10.1111/1755-5922.12254.

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Abstract

Introduction: Contemporary Australian data regarding antithrombotic prescribing patterns following approval of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) are limited.Aim: The aim of the present study was to assess antithrombotic prescribing patterns before, during and after the clinical introduction of DOACs.Methods: Using digital medical records, this retrospective cohort study included all patients with AF as a primary or secondary diagnosis who were admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015.Results: Antithrombotic agents were prescribed for 2078 (91.9%) of 2261 patients without documented contraindication to therapy. Higher rates of OAC prescribing were observed following Government subsidization of DOACs in Quarter 3 (Q3) 2013 than anticoagulation rates in the prior quarters, (54.4% in Q3, 2013 to 68.1% in Q2, 2015, p p p = 0.04) and had lower stroke and bleeding risk scores (CHA2DS2-VASc 2.8 vs. 3.3, p = 0.03, HAS -BLED 2 vs. 3, p  = 0.04) than patients who were newly prescribed warfarin.Conclusions: DOACs rapidly became the most commonly prescribed class of antithrombotic medications in patients with AF soon after they became widely available. Warfarin and antiplatelet prescribing declined significantly, although a substantial proportion of patients continued to be prescribed antiplatelet therapy. Patients who were initiated on DOACs were typically younger with fewer comorbid conditions compared to those initiated on warfarin therapy.

Item Type: Article
Authors/Creators:Admassie, E and Chalmers, L and Bereznicki, LR
Keywords: AF, elderly, DOACs
Journal or Publication Title: Cardiovascular Therapeutics
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 1755-5922
DOI / ID Number: 10.1111/1755-5922.12254
Copyright Information:

Copyright 2017 Wiley

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