144183-Ten-Year Trends in the Use of Oral Anticoagulants in Australian General Practice Patients With Atrial Fibrillation 2021 (1).pdf (986.53 kB)
Ten-Year trends in the use of oral anticoagulants in Australian general practice patients with atrial fibrillation
journal contributionposted on 2023-05-20, 23:05 authored by Woldesellassie BezabheWoldesellassie Bezabhe, Luke BereznickiLuke Bereznicki, Janette RadfordJanette Radford, Barbara Wimmer, Colin CurtainColin Curtain, Mohammed SalahudeenMohammed Salahudeen, Gregory PetersonGregory Peterson
Objective: Appropriate use of oral anticoagulants (OACs) reduces the risk of stroke in patients with atrial fibrillation (AF). The study characterized the prescribing of OACs in people with AF in the Australian primary care setting over 10 years. Design: Retrospective population study. Setting and Participants: We performed 10 sequential cross-sectional analyses of patients with a recorded diagnosis of AF between 2009 and 2018 using national general practice data. The proportion of patients with AF who were prescribed an OAC based on their stroke risk was examined. Primary and secondary outcomes: The primary outcome was the proportion of high stroke risk patients who were prescribed an OAC over a decade. The secondary outcome was variation in OAC prescribing among general practices. Results: The sample size of patients with AF ranged from 9,874 in 2009 to 41,751 in 2018. The proportion who were prescribed an OAC increased from 39.5% (95% CI 38.6–40.5%) in 2009 to 52.0% (95% CI 51.5–52.4%) in 2018 (p for trend < 0.001). During this time, the proportion of patients with AF and high stroke risk who were prescribed an OAC rose from 41.7% (95% CI 40.7–42.8%) to 55.2% (95% CI 54.7–55.8%; p for trend < 0.001) with the direct-acting oral anticoagulants accounting for over three-quarters of usage by 2018. There was substantial variation in OAC prescribing between general practices. In 2018, the proportion of moderate to high stroke risk patients who were prescribed an OAC was 38.6% (95% CI 37.2–40.1%) in the lowest practice site quintiles and 65.6% (95% CI 64.5–66.7%) in the highest practice site quintiles. Conclusions: Over the 10 years, OAC prescribing in high stroke risk patients with AF increased by one-third. There was considerable variation in OAC prescribing between general practices.
Publication titleFrontiers in Pharmacology
Department/SchoolSchool of Pharmacy and Pharmacology
PublisherFrontiers Research Foundation
Place of publicationSwitzerland
Rights statementCopyright 2021 Bezabhe, Bereznicki, Radford, Wimmer, Curtain, Salahudeen and Peterson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).