Details

Autor(en) / Beteiligte

• Rottura, M.
• Drago, S.F.A.
• Molonia, A.
• Irrera, N.
• Marino, S.
• Scoglio, R.
• Orlando, L.
• Gigliotti De Fazio, M.
• Squadrito, F.
• Arcoraci, V.
• Imbalzano, E.

Titel

Prescriptive behavior of non-vitamin K oral anticoagulants in patients affected by atrial fibrillation in general practice

Ist Teil von

• Biomedicine & pharmacotherapy, 2023-09, Vol.165, p.115020-115020, Article 115020

Ort / Verlag

France: Elsevier Masson SAS

Erscheinungsjahr

2023

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and in recent years the pharmacological approach has been strongly implemented; in Italy, the prescription of the non-vitamin K oral anticoagulants (NOAC) was also extended to General Practitioners (GPs) since 2020. The aim of the present study was to investigate the GPs prescribing behaviour of NOACs. An observational study was performed by using the computerized medical record of 14 GPs in Sicily: patients affected by AF were selected and stratified according to the prescribed antithrombotic drugs. Patients were considered inadequately managed if antithrombotic treatment was not adherent to recent ESC guidelines. A total of 467 (2.7 %) patients were affected by AF, 276 (59.1 %) were treated with an oral anticoagulant (OAC) regardless the high stroke risk (OR 1.64; 95 %CI 0.74–3.62; p = 0.226). The NOAC users were 236 patients as follow: Rivaroxaban 33.5 %, Apixaban 33,1 %, Dabigatran 17,4 %, Edoxaban 16.1 %. In 7 patients an inappropriate NOAC treatment was observed. Among Vitamin-K antagonist users, 25.0 % were considered inappropriate. Patients not treated with OAC were 191, of them 81.7 % were at high stroke risk and did not receive any OAC despite the indication to treat. In addition, the probability to be not properly managed significantly increased in older and in patients with atherosclerosis. Conversely, patients with at least one reported cardiology counselling significantly reduced the likelihood to be not properly managed (OR 0.38, 95 %CI 0.25–0.58; p 0.01). Our results suggest the need to optimize the management of real-life AF patients by improving prescribing adherence to ESC guidelines. [Display omitted] •Among 467 AF patients 191 were not treated with OAC and 81.7 % of them required OAC.•High stroke risk did not influence the probability of oral anticoagulant treatment.•Patients treated with NOACs were 236, of them 7 had inappropriate prescriptions.•Patients not managed in accordance with the EHRA/ESC guidelines were 173 (37.0 %).•Cardiological counselling improved the management of AF patients