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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, 15, (3) pp. 351-357. 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 |
| Web of Science® Times Cited: | 1 |
| Deposited By: | Pharmacy |
| Deposited On: | 2022-02-20 |
| Last Modified: | 2022-10-12 |
| Downloads: | 0 |
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