| アブストラクト | Patients with Type 2 diabetes mellitus (T2DM) have an increased risk of atrial fibrillation (AF). The current study aimed to investigate the prevalence and treatment of AF in patients with T2DM, assess the impact of direct oral anticoagulants (DOACs) introduction on oral anticoagulant (OACs) prescribing rates, and factors associated with OAC initiations in patients with T2DM and AF. The Health Improvement Network (THIN) database (2001-2016), was used to examine the annual prevalence and treatment of AF in T2DM. The impact of DOACs introduction on OAC prescribing rates were investigated using interrupted time series analysis (ITS). Factors associated with OAC initiations were also identified using multivariate logistic regression. The prevalence of AF increased from 2.7 [95% confidence intervals (CI) 2.5-2.8] in 2001 to 5.0 (4.9-5.1) in 2016 per 100 persons. OACs prescribing within 30-days of AF diagnosis increased from 21.5% in 2001 to 56.8% in 2016. ITS analysis showed that OAC prescribing increased after DOAC introduction (P < 0.001), however, no immediate change was observed (P = 0.29). T2DM patients with AF, aged 60-79, male gender and BMI >/= 25 were more likely to receive OAC, adjusted OR 1.3 (1.2-1.5) for aged 60-79, 1.3 (1.2-1.4) for male gender and 2.0 (1.9-2.2) for BMI >/= 25, respectively. This study highlighted an increase in prevalence of AF in patients with T2DM during the study period. Further studies are warranted to investigate factors contributing to the underuse of OAC in patients with T2DM and AF. |
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| 投稿者 | Alwafi, Hassan; Wong, Ian C K; Banerjee, Amitava; Mongkhon, Pajaree; Whittlesea, Cate; Naser, Abdallah Y; Lau, Wallis C Y; Wei, Li |
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| 組織名 | Research Department of Practice and Policy, School of Pharmacy, University;College London, 29-39 Brunswick Square, London, WC1N 1AX, UK.;Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia.;Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and;Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam,;Hong Kong.;Institute of Health Informatics, University College London, London, UK.;Barts Health NHS Trust, London, UK.;Division of Pharmacy Practice, Department of Pharmaceutical Care, School of;Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.;Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy,;Chiang Mai University, Chiang Mai, Thailand.;Faculty of Pharmacy, Isra University, Amman, Jordan.;College London, 29-39 Brunswick Square, London, WC1N 1AX, UK. l.wei@ucl.ac.uk. |
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