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Switching of oral anticoagulants in atrial fibrillation: a cohort study using Australian general practice data

Kefale, AT, Peterson, GM ORCID: 0000-0002-6764-3882, Bezabhe, WM ORCID: 0000-0002-3028-6949 and Bereznicki, LR ORCID: 0000-0003-3974-3437 2022 , 'Switching of oral anticoagulants in atrial fibrillation: a cohort study using Australian general practice data' , Expert Review of Clinical Pharmacology , pp. 1-24 , doi: 10.1080/17512433.2022.2044793.

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Background : We assessed switching patterns of anticoagulants in patients with atrial fibrillation (AF) in the period following widespread availability of the direct-acting oral anticoagulants (DOACs).Research design and methods : A retrospective cohort study was conducted using NPS MedicineWise’s MedicineInsight dataset, collected from Australian general practices. Patients with AF who newly commenced an OAC between 1 January 2013 and 30 September 2017 were included. The switching rate was calculated within 12 months post-initiation. Switching rates between OACs were compared, and predictors of switching were identified.Results : We included 15,020 patients who were recorded as having been commenced on warfarin or a DOAC. Overall, 5.7% of patients switched their OAC within 12 months. The switching rates from warfarin, apixaban, dabigatran and rivaroxaban were 9.4%, 2.6%, 8.9% and 4.0%, respectively. Compared to apixaban, commencement on warfarin, dabigatran or rivaroxaban was associated with a higher risk of switching to another OAC. Patients with an estimated GFR 60mL/min.Conclusion : There was a low switching rate between OACs in Australian general practice patients with AF. A key determinant of switching appeared to be kidney disease.

Item Type: Article
Authors/Creators:Kefale, AT and Peterson, GM and Bezabhe, WM and Bereznicki, LR
Keywords: atrial fibrillation, Australia, determinants, anticoagulants, general practice, switching, warfarin
Journal or Publication Title: Expert Review of Clinical Pharmacology
Publisher: Taylor & Francis
ISSN: 1751-2433
DOI / ID Number: 10.1080/17512433.2022.2044793
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© 2022 Informa UK Limited, trading as Taylor & Francis Group

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