Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation.
Pharmaco-economics
thromboembolism
vitamin K antagonists
Journal
JRSM cardiovascular disease
ISSN: 2048-0040
Titre abrégé: JRSM Cardiovasc Dis
Pays: England
ID NLM: 101598607
Informations de publication
Date de publication:
Historique:
received:
01
09
2019
revised:
06
02
2020
accepted:
25
02
2020
entrez:
15
4
2020
pubmed:
15
4
2020
medline:
15
4
2020
Statut:
epublish
Résumé
Prevention of thromboembolism by novel oral anticoagulants is increasing, whilst use of vitamin K antagonists is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular atrial fibrillation between 2014 and 2018. One-hundred and sixty-two consecutive patients (95 men, 67 women) with non-valvular atrial fibrillation, mean age 72.3 years (standard deviation = 11.0), underwent cardiac assessment in a single cardiac unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed novel oral anticoagulants and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change using a Joinpoint Regression Program 4.7.0.0. There were diverging trends in anticoagulant treatment from 2014 to 2018 without join points: yearly increase in novel oral anticoagulant treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, average annual percentage change = 16.2%, 95% confidence interval = 5.8% to 27.5%, Changing trends in treatment with anticoagulants for patients with non-valvular atrial fibrillation observed within less than two years provide important information to healthcare services to estimate future pharmaco-economic costs for such treatments.
Sections du résumé
BACKGROUND
BACKGROUND
Prevention of thromboembolism by novel oral anticoagulants is increasing, whilst use of vitamin K antagonists is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular atrial fibrillation between 2014 and 2018.
METHODS
METHODS
One-hundred and sixty-two consecutive patients (95 men, 67 women) with non-valvular atrial fibrillation, mean age 72.3 years (standard deviation = 11.0), underwent cardiac assessment in a single cardiac unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed novel oral anticoagulants and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change using a Joinpoint Regression Program 4.7.0.0.
RESULTS
RESULTS
There were diverging trends in anticoagulant treatment from 2014 to 2018 without join points: yearly increase in novel oral anticoagulant treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, average annual percentage change = 16.2%, 95% confidence interval = 5.8% to 27.5%,
CONCLUSIONS
CONCLUSIONS
Changing trends in treatment with anticoagulants for patients with non-valvular atrial fibrillation observed within less than two years provide important information to healthcare services to estimate future pharmaco-economic costs for such treatments.
Identifiants
pubmed: 32284860
doi: 10.1177/2048004020915406
pii: 10.1177_2048004020915406
pmc: PMC7119231
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2048004020915406Informations de copyright
© The Author(s) 2020.
Références
Chest. 2015 Jan;147(1):109-119
pubmed: 24921459
Int J Clin Pract. 2009 Apr;63(4):630-41
pubmed: 19222611
Int J Gen Med. 2015 Sep 07;8:283-91
pubmed: 26379443
Europace. 2014 Dec;16(12):1720-5
pubmed: 25087153
Intern Emerg Med. 2016 Apr;11(3):289-93
pubmed: 26972708
Circulation. 2006 Jul 11;114(2):119-25
pubmed: 16818816
Clin Ther. 2015 Nov 1;37(11):2506-2514.e4
pubmed: 26481493
Br J Clin Pharmacol. 2017 Sep;83(9):2096-2106
pubmed: 28390065
Circulation. 2014 Feb 25;129(8):837-47
pubmed: 24345399
Eur Heart J. 2010 Oct;31(19):2369-429
pubmed: 20802247
Am J Cardiol. 2009 Dec 1;104(11):1534-9
pubmed: 19932788
Thromb Haemost. 2016 Jan;115(1):31-9
pubmed: 26246112
J Cardiol. 2017 Jun;69(6):868-876
pubmed: 27889397
Lancet. 2015 Aug 15;386(9994):680-90
pubmed: 26088268
J Am Heart Assoc. 2017 Apr 28;6(5):
pubmed: 28455344
BMJ Open. 2017 Dec 14;7(12):e019122
pubmed: 29247109
Circulation. 2011 Oct 4;124(14):1573-9
pubmed: 21900088
Eur J Cardiothorac Surg. 2016 Nov;50(5):e1-e88
pubmed: 27663299
Int J Cardiol. 2013 Aug 20;167(4):1237-41
pubmed: 22494863
Lancet. 2016 Aug 20;388(10046):806-17
pubmed: 27560276
Eur Heart J. 2013 Sep;34(35):2746-51
pubmed: 23900699
Lancet. 2015 Jul 11;386(9989):154-62
pubmed: 25960110
Eur Heart J. 2013 Jul;34(27):2094-106
pubmed: 23625209
Am J Cardiol. 1998 Oct 16;82(8A):2N-9N
pubmed: 9809895
BMJ Open. 2018 Jul 11;8(7):e022558
pubmed: 29997144
Open Heart. 2016 Jan 18;3(1):e000279
pubmed: 26848392
BMJ Open. 2018 Jan 24;8(1):e019638
pubmed: 29371284