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Switching of oral anticoagulants in atrial fibrillation: a cohort study using Australian general practice data

Citation

Kefale, AT and Peterson, GM and Bezabhe, WM and Bereznicki, LR, Switching of oral anticoagulants in atrial fibrillation: a cohort study using Australian general practice data, Expert Review of Clinical Pharmacology pp. 1-24. ISSN 1751-2433 (2022) [Refereed Article]

Copyright Statement

© 2022 Informa UK Limited, trading as Taylor & Francis Group

DOI: doi:10.1080/17512433.2022.2044793

Abstract

Background

: We assessed switching patterns of anticoagulants in patients with atrial fibrillation (AF) in the period following widespread availability of the direct-acting oral anticoagulants (DOACs).

Research design and methods

: A retrospective cohort study was conducted using NPS MedicineWise’s MedicineInsight dataset, collected from Australian general practices. Patients with AF who newly commenced an OAC between 1 January 2013 and 30 September 2017 were included. The switching rate was calculated within 12 months post-initiation. Switching rates between OACs were compared, and predictors of switching were identified.

Results

: We included 15,020 patients who were recorded as having been commenced on warfarin or a DOAC. Overall, 5.7% of patients switched their OAC within 12 months. The switching rates from warfarin, apixaban, dabigatran and rivaroxaban were 9.4%, 2.6%, 8.9% and 4.0%, respectively. Compared to apixaban, commencement on warfarin, dabigatran or rivaroxaban was associated with a higher risk of switching to another OAC. Patients with an estimated GFR <30 mL/min were more likely to switch from DOACs to warfarin and less likely to switch from warfarin, compared to those with an estimated GFR >60mL/min.

Conclusion

: There was a low switching rate between OACs in Australian general practice patients with AF. A key determinant of switching appeared to be kidney disease.

Item Details

Item Type:Refereed Article
Keywords:atrial fibrillation, Australia, determinants, anticoagulants, general practice, switching, warfarin
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiovascular medicine and haematology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Efficacy of medications
UTAS Author:Kefale, AT (Mr Adane Kefale)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Bezabhe, WM (Dr Woldesellassie Bezabhe)
UTAS Author:Bereznicki, LR (Professor Luke Bereznicki)
ID Code:148918
Year Published:2022
Deposited By:Pharmacy
Deposited On:2022-02-20
Last Modified:2022-03-17
Downloads:0

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