| アブストラクト | OBJECTIVE: To describe the changes in prescribing of oral anticoagulant (AC) and antiplatelet (AP) agents in patients with non-valvular atrial fibrillation (NVAF) in the UK and to identify the characteristics associated with deviation from guideline-based recommendations. DESIGN: Five cross-sectional analyses in a large retrospective population-based cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Datalink. PARTICIPANTS: The study included patients with a diagnosis of NVAF and eligible for anticoagulation (CHA2DS2-VASc score >/=2) on 1 April of 2012, 2013, 2014, 2015 and 1st January 2016. RESULTS: The proportion of patients being treated with AC increased at each index date, showing an absolute rise of 16.7% over the study period. At the same time, the proportion of patients treated with an AP alone was reduced by half, showing an absolute decrease of 16.8%. The proportion of patients not receiving any antithrombotic (AT) treatment remained the same across the study period. A number of predictors were identified for AP alone or no treatment compared with AC treatment. CONCLUSION: Major improvements in the AT management of patients with NVAF for stroke prevention in the UK were observed between April 2012 and January 2016. Despite this, nearly 20% of at-risk patients still received AP alone and over 15% were on no AT agents in January 2016. |
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| ジャーナル名 | BMJ open |
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| 投稿日 | 2017/9/28 |
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| 投稿者 | Lacoin, Laure; Lumley, Matthew; Ridha, Essra; Pereira, Marta; McDonald, Laura; Ramagopalan, Sreeram; Lefevre, Cinira; Evans, David; Halcox, Julian P |
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| 組織名 | UK Medical Department, Bristol-Myers Squibb, Uxbridge, UK.;Medical Department, Pfizer, Tadworth, UK.;Real-World Evidence, Evidera, London, UK.;Center of Observational Research and Data Sciences, Business Insights and;Analytics, Bristol-Myers Squibb, Rueil Malmaison, France.;Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Rueil;Malmaison, France.;Department of Cardiology, Swansea University, Cardiff, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28951401/ |
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