Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross-sectional baseline analysis in general practice

Bajorek, B; Magin, PJ; Hilmer, S; Krass, I

Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross-sectional baseline analysis in general practice

Bajorek, B

Magin, PJ Hilmer, S Krass, I

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Publication Type:: Journal Article
Citation:: Journal of Clinical Pharmacy and Therapeutics, 2016, 41 (4), pp. 432 - 440
Issue Date:: 2016-08-01

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Field	Value	Language
dc.contributor.author	Bajorek, B https://orcid.org/0000-0002-2532-7187	en_US
dc.contributor.author	Magin, PJ	en_US
dc.contributor.author	Hilmer, S	en_US
dc.contributor.author	Krass, I	en_US
dc.date.available	2016-05-18	en_US
dc.date.issued	2016-08-01	en_US
dc.identifier.citation	Journal of Clinical Pharmacy and Therapeutics, 2016, 41 (4), pp. 432 - 440	en_US
dc.identifier.issn	0269-4727	en_US
dc.identifier.uri	http://hdl.handle.net/10453/122779
dc.description.abstract	© 2016 John Wiley & Sons Ltd What is known and objective: Antithrombotics for stroke prevention in atrial fibrillation (AF) are reportedly underutilised. Since the burden of care lies within general practice, attention must be paid to identifying and addressing practice gaps in this setting. The objective of this study was to determine the contemporary utilisation of antithrombotic therapy for stroke prevention in AF within Australian general practice (GP). Methods: Data pertaining to AF patients’ (aged ≥65 years) were collected from GP surgeries in New South Wales, Australia, using purpose-designed data collection forms; extracted data comprised patients’ medical histories, current pharmacotherapy, and relevant characteristics. Results and Discussion: Data pertaining to 393 patients (mean age 78·0 ± 7·0 years) were reviewed. Overall, most (98·5%) patients received antithrombotic therapy. Among the 387 patients using antithrombotics, most (94·1%) received mono-therapy. “Warfarin ± antiplatelet” was most frequently used (81·7%); 77·5% used “warfarin” as a monotherapy, followed by “dabigatran ± clopidogrel” (11·6%), “aspirin” (5·9%) and “clopidogrel” alone (0·8%). High stroke risk and low bleeding risk were associated with increased use of “warfarin ± antiplatelet” therapy. Older patients (≥80 years) were more likely to receive ‘nil therapy’ (P = 0·04), and less likely to receive dual and triple antithrombotic therapy. 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.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT0632799
dc.relation.ispartof	Journal of Clinical Pharmacy and Therapeutics	en_US
dc.relation.isbasedon	10.1111/jcpt.12409	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Atrial Fibrillation	en_US
dc.subject.mesh	Hemorrhage	en_US
dc.subject.mesh	Warfarin	en_US
dc.subject.mesh	Fibrinolytic Agents	en_US
dc.subject.mesh	Anticoagulants	en_US
dc.subject.mesh	Drug Therapy, Combination	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Cross-Sectional Studies	en_US
dc.subject.mesh	Age Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Stroke	en_US
dc.subject.mesh	General Practice	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.title	Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross-sectional baseline analysis in general practice	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	41	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	41	en_US

Abstract:

© 2016 John Wiley & Sons Ltd What is known and objective: Antithrombotics for stroke prevention in atrial fibrillation (AF) are reportedly underutilised. Since the burden of care lies within general practice, attention must be paid to identifying and addressing practice gaps in this setting. The objective of this study was to determine the contemporary utilisation of antithrombotic therapy for stroke prevention in AF within Australian general practice (GP). Methods: Data pertaining to AF patients’ (aged ≥65 years) were collected from GP surgeries in New South Wales, Australia, using purpose-designed data collection forms; extracted data comprised patients’ medical histories, current pharmacotherapy, and relevant characteristics. Results and Discussion: Data pertaining to 393 patients (mean age 78·0 ± 7·0 years) were reviewed. Overall, most (98·5%) patients received antithrombotic therapy. Among the 387 patients using antithrombotics, most (94·1%) received mono-therapy. “Warfarin ± antiplatelet” was most frequently used (81·7%); 77·5% used “warfarin” as a monotherapy, followed by “dabigatran ± clopidogrel” (11·6%), “aspirin” (5·9%) and “clopidogrel” alone (0·8%). High stroke risk and low bleeding risk were associated with increased use of “warfarin ± antiplatelet” therapy. Older patients (≥80 years) were more likely to receive ‘nil therapy’ (P = 0·04), and less likely to receive dual and triple antithrombotic therapy. 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.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/122779