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Using primary care data to assess comparative effectiveness and safety of apixaban and rivaroxaban in patients with nonvalvular atrial fibrillation in the UK: an observational cohort study
Conclusions Among patients with nonvalvular AFib, apixaban was as effective as rivaroxaban in reducing rate of stroke and safer in terms of major bleeding episodes. This head-to-head comparison supports conclusions drawn from indirect comparisons of DOAC trials against warfarin and demonstrates the potential for real-world evidence to fill evidence gaps and reduce uncertainty in both health technology assessment decision-making and clinical guideline development.
Source: BMJ Open - October 17, 2022 Category: General Medicine Authors: Jaksa, A., Gibbs, L., Kent, S., Rowark, S., Duffield, S., Sharma, M., Kincaid, L., Ali, A. K., Patrick, A. R., Govil, P., Jonsson, P., Gatto, N. Tags: Open access, Cardiovascular medicine Source Type: research

Prescribing of direct oral anticoagulants and warfarin to older people with atrial fibrillation in UK general practice: a cohort study
Anticoagulation for stroke prevention in atrial fibrillation (AF) has, historically, been under-used in older people. The aim of this study was to investigate prescribing of oral anticoagulants (OACs) for peop...
Source: BMC Medicine - August 31, 2021 Category: Internal Medicine Authors: Anneka Mitchell, Julia Snowball, Tomas J. Welsh, Margaret C. Watson and Anita McGrogan Tags: Research article Source Type: research

Uptake of Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation in a Single Clinical Commissioning Group in England Without Restrictions to Their Use
ConclusionsThe early use of DOACs, in a CCG without restrictions to their use, was embraced by primary-care prescribers in this particular CCG.
Source: Clinical Drug Investigation - February 25, 2019 Category: Drugs & Pharmacology Source Type: research

The relationship between knowledge, health literacy, and adherence among patients taking oral anticoagulants for stroke thromboprophylaxis in atrial fibrillation
ConclusionSignificant correlations between health literacy, OAC knowledge, and adherence were observed, and these relationships should to be considered by health professionals responsible for monitoring patients who are prescribed anticoagulants. We also observed serious gaps in OAC knowledge. Interventions designed to optimize the outcomes of anticoagulant treatment need to address these factors.
Source: Cardiovascular Therapeutics - September 25, 2017 Category: Cardiology Authors: Chanelle A. Rolls, Kehinde O. Obamiro, Leanne Chalmers, Luke R. E. Bereznicki Tags: ORIGINAL RESEARCH ARTICLE Source Type: research

The relationship between knowledge, health literacy and adherence among patients taking oral anticoagulants for stroke thromboprophylaxis in atrial fibrillation
ConclusionSignificant correlations between health literacy, OAC knowledge and adherence were observed, and these relationships should to be considered by health professionals responsible for monitoring patients who are prescribed anticoagulants. We also observed serious gaps in OAC knowledge. Interventions designed to optimize the outcomes of anticoagulant treatment need to address these factors.This article is protected by copyright. All rights reserved.
Source: Cardiovascular Therapeutics - August 1, 2017 Category: Cardiology Authors: Chanelle A Rolls, Kehinde O Obamiro, Leanne Chalmers, Luke R E Bereznicki Tags: Original Research Article Source Type: research

Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross‐sectional baseline analysis in general practice
Conclusion: We found an encouraging improvement compared to previous studies in the utilisation of antithrombotic therapy for stroke prevention in AF within general practice. Warfarin is now utilised as the mainstay therapy, followed by aspirin, although the novel oral anticoagulants are entering the spectrum of therapies used. Consideration needs to be given to the potential impact of the newer agents and their scope of use. There has been an encouraging temporal improvement in the utilization of antithrombotic therapy for stroke prevention in AF within general practice. Anticoagulants (mostly warfarin) are now utilized ...
Source: Journal of Clinical Pharmacy and Therapeutics - June 23, 2016 Category: Drugs & Pharmacology Authors: B. Bajorek, P. J. Magin, S. Hilmer, I. Krass Tags: Original Article Source Type: research

Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross ‐sectional baseline analysis in general practice
Conclusion: We found an encouraging improvement compared to previous studies in the utilisation of antithrombotic therapy for stroke prevention in AF within general practice. Warfarin is now utilised as the mainstay therapy, followed by aspirin, although the novel oral anticoagulants are entering the spectrum of therapies used. Consideration needs to be given to the potential impact of the newer agents and their scope of use. There has been an encouraging temporal improvement in the utilization of antithrombotic therapy for stroke prevention in AF within general practice. Anticoagulants (mostly warfarin) are now utilized ...
Source: Journal of Clinical Pharmacy and Therapeutics - June 23, 2016 Category: Drugs & Pharmacology Authors: B. Bajorek, P. J. Magin, S. Hilmer, I. Krass Tags: Original Article Source Type: research

Primary Care Atrial Fibrillation Service: outcomes from consultant-led anticoagulation assessment clinics in the primary care setting in the UK
Conclusions Systematic identification of patients with AF with high stroke-risk and consultation in PCAF consultant-led clinics effectively delivers oral anticoagulation to high-risk patients with AF in the community.
Source: BMJ Open - December 9, 2015 Category: Journals (General) Authors: Das, M., Panter, L., Wynn, G. J., Taylor, R. M., Connor, N., Mills, J. D., Kirchhof, P., Gupta, D. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Pharmacology and therapeutics Research Source Type: research

Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation.
CONCLUSIONS: -In general practice settings, dabigatran was associated with reduced risk of ischemic stroke, intracranial hemorrhage, and death, and increased risk of major gastrointestinal hemorrhage compared with warfarin in elderly patients with non-valvular AF. These associations were most pronounced in patients treated with dabigatran 150 mg twice daily, whereas the association of 75 mg twice daily with study outcomes was indistinguishable from warfarin except for a lower risk of intracranial hemorrhage with dabigatran. PMID: 25359164 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2014 Category: Cardiology Authors: Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, Sheu TC, Mott K, Goulding MR, Houstoun M, MaCurdy TE, Worrall C, Kelman JA Tags: Circulation Source Type: research

Warfarin therapy for atrial fibrillation in general practice - is bleeding risk underestimated?
Abstract BACKGROUND Atrial fibrillation causes a five-fold increase in the risk of thromboembolic stroke. Warfarin therapy reduces the risk by 64 %, but increases the risk of serious bleeding. We aimed to investigate the quality of warfarin therapy in a general practice and determine which patients would be likely to benefit from the treatment.MATERIAL AND METHOD We carried out retrospective registration of patients with atrial fibrillation, and calculated the risk of thromboembolism (CHA2DS2-VASc score) and of bleeding (HAS-BLED score) for each patient. Two alternative methods were used for calculating the absol...
Source: Tidsskrift for den Norske Laegeforening - January 28, 2014 Category: Journals (General) Authors: Bratland B, Hornnes MB Tags: Tidsskr Nor Laegeforen Source Type: research

Ethnicity and stroke risk in patients with atrial fibrillation
Conclusions Despite a reduced prevalence of AF among South Asian patients, their risk of stroke is higher than for white patients or black African/Caribbean patients in association with diabetes, cardiovascular disease, and hypertension. Under-prescription of anticoagulation persists in all ethnic groups, a deficit most pronounced in the elderly. Use of the CHA2DS2VASc score would enhance optimal management in primary care.
Source: Heart - July 5, 2013 Category: Cardiology Authors: Mathur, R., Pollara, E., Hull, S., Schofield, P., Ashworth, M., Robson, J. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Heart rhythm disorders Source Type: research

Potential impact of new oral anticoagulants on the management of atrial fibrillation‐related stroke in primary care
ConclusionThe clinical and economic benefits of the new oral anticoagulants, along with appropriate risk stratification, may enable a higher number of patients with AF to receive effective and convenient prophylaxis for stroke prevention.
Source: International Journal of Clinical Practice - April 28, 2013 Category: Internal Medicine Authors: K. Harris, J. Mant Tags: Review Article Source Type: research

Stroke prophylaxis in high-risk patients with atrial fibrillation: Rhythm vs. rate control strategy.
CONCLUSIONS: Anti-thrombotic prophylaxis in CHADS₂ ≥2 patients is different in subjects assigned to the Rhythm vs. the Rate control strategy, as well as reported reasons for warfarin non use. GPs do not know why warfarin is not used in a large percentage of cases, mainly in the rhythm control strategy group. Improving efforts should probably be differently tailored for patients assigned to the "rhythm" or the "rate" control strategy. PMID: 23474251 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - March 5, 2013 Category: Internal Medicine Authors: Filippi A, Zoni-Berisso M, Ermini G, Landolina M, Brignoli O, D'Ambrosio G, Zingarini G, Pedrinazzi C Tags: Eur J Intern Med Source Type: research