• Atencion primaria · Oct 2020

    The use and adherence of oral anticoagulants in Primary Health Care in Catalunya, Spain: A real-world data cohort study.

    • Maria Giner-Soriano, Jordi Cortes, Ainhoa Gomez-Lumbreras, Oriol Prat-Vallverdú, Mª Angeles Quijada-Manuitt, and Rosa Morros.
    • Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain; Institut Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain.
    • Aten Primaria. 2020 Oct 1; 52 (8): 529-538.

    ObjectiveWe aimed to describe sociodemographic, comorbidities, co-medication and risk of thromboembolic events and bleeding in patients with NVAF initiating oral anticoagulants (OAC) for stroke prevention, and to estimate adherence and persistence to OAC.SettingPrimary Health Care (PHC) in the Catalan Health Institute (ICS), Catalunya, Spain.ParticipantsAll NVAF adult patients initiating OAC for stroke prevention in August 2013-December 2015.MethodsPopulation-based cohort study. Persistence was measured in patients initiating OAC in August 2013-December 2014.Data SourceSIDIAP, which captures electronic health records from PHC in the (ICS), covering approximately 5.8 million people.Results51,690 NVAF patients initiated OAC; 47,197 (91.3%) were naive to OAC and 32,404 (62.7%) initiated acenocoumarol. Mean age was 72.8 years (SD 12.3) and 49.4% were women. Platelet-aggregation inhibitors were taken by 9105 (17.6%) of the patients. Persistence and adherence were estimated up to the end of follow-up. For 22,075 patients, persistence was higher among the non-naive patients [n=258 (61.7%)] than among the naive [n=11,502 (53.1%)]. Adherence was estimated for patients initiating DOAC and it was similar in naive and non-naive patients. Among the naive to DOAC treatment, those starting rivaroxaban showed a highest proportion [(n=360 (80.1%)] of good adherence at implementation (MPR>80%) while patients starting dabigatran were less adherent [n=203 (47.8%)].ConclusionsAcenocoumarol was the most frequently prescribed OAC as first therapy in NVAF patients. Non-naive to DOAC showed better persistence than naive. Rivaroxaban showed higher proportion of adherent patients during the implementation phase than apixaban and dabigatran the lowest.Copyright © 2020 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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