Clinical characteristics of patients with atrial fibrillation treated with direct oral anticoagulants attended in primary care setting. The SILVER-AP study
Por:
de la Figuera, M, Cinza, S, Marin, N, Egocheaga, I, Prieto, MA
Publicada:
1 jun 2018
Resumen:
Objective: To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC).
Design: Observational, cross-sectional and multicentre study.
Location: Autonomous Communities in which the general practitioner can prescribe DOAC (n = 9).
Participants: The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months.
Main measures: A record was made of the sociodemographic and clinical management date.
Results: Mean age was 78.6 +/- 8.4 years, and 50.5% of patients were men. Mean CHADS(2) score was 2.6 +/- 1.2, mean CHA(2)DS(2)-VASc score was 4.3 +/- 1.6, and the mean HAS-BLED score was 2.3 +/- 1.0. Mean duration of treatment with DOAC was 15.8 +/- 12.5 months. Rivaroxaban was the DOAC most frequently prescribed (57.8%), followed by dabigatran (23.7%), and apixaban (18.5%). Of the patients receiving rivaroxaban, 70.2% were taking the dose of 20 mg/daily. Of the patients receiving dabigatran, 41.7% were taking the dose of 150 mg twice daily, and in the case of apixaban, 56.2% were taking the dose of 5 mg twice daily. Satisfaction (ACTS Burdens scale 52.0 +/- 7.2 and ACTS Benefits scale 12.1 +/- 2.2), and therapeutic adherence (97.8% of patients took their medication regularly) with DOAC were high.
Conclusions: Patients treated with DOAC in Spain have a high thromboembolic risk. A significant proportion of patients receive a lower dose of DOAC than that recommended according to their clinical profile. Satisfaction and medication adherence are high. (C) 2017 Elsevier Espana, S.L.U.
Filiaciones:
de la Figuera, M:
Ctr Atencio Primaria CAP Sardenya, Barcelona, Spain
Cinza, S:
Ctr Saude CS Porto Son, Santiago De Compostela, Spain
Marin, N:
Bayer Hispania SL, Gen Med CV, Barcelona, Spain
Egocheaga, I:
Ctr Salud Isla Oza, Madrid, Spain
Prieto, MA:
Ctr Salud CS Vallobin La Florida, Oviedo, Spain
Gold, Green Published
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