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Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors' adherence to warfarin therapy recommendations

Carlsson, Axel C. ; Wandell, Per ; Sundquist, Kristina LU ; Johansson, Sven-Erik LU and Sundquist, Jan LU (2013) In European Journal of Clinical Pharmacology 69(2). p.245-253
Abstract
Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden. The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors' adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e., congestive heart failure, hypertension, age > 75 years, diabetes, previous stroke and transient ischemic attack. Data were obtained from primary health care records that contained individual clinical data. In total, 371,036 patients were included in the sample from 2002, and 424,329 patients were included in the sample from 2007. The study population consisted of individuals aged 45+ years who were diagnosed... (More)
Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden. The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors' adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e., congestive heart failure, hypertension, age > 75 years, diabetes, previous stroke and transient ischemic attack. Data were obtained from primary health care records that contained individual clinical data. In total, 371,036 patients were included in the sample from 2002, and 424,329 patients were included in the sample from 2007. The study population consisted of individuals aged 45+ years who were diagnosed with AF in 2002 (1,330 men and 1,096 women) and 2007 (2,748 men and 2,234 women). The pharmacotherapies prescribed in 2002 and 2007 were analyzed separately in men and women. Logistic regression was used to calculate the association between the CHADS2 score and prescribed warfarin treatment. Selective beta-blockers, anti-coagulant therapy and lipid-lowering drugs were prescribed more frequently in 2007 than in 2002. In 2007, antithrombotic and RAS-blocking agents were prescribed more frequently to men, whereas beta-1 selective beta-blockers were prescribed more frequently to women. There was no consistent association between the CHADS2 score and prescribed warfarin treatment. Pharmacotherapy of AF has improved over time, though CHADS2 guidelines need to be implemented systematically in primary health care in Sweden to decrease the risk of stroke and improve quality of life in patients with AF. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial fibrillation, Pharmacotherapy, Gender, Warfarin, CHADS2, Sweden
in
European Journal of Clinical Pharmacology
volume
69
issue
2
pages
245 - 253
publisher
Springer
external identifiers
  • wos:000313791600013
  • scopus:84873702791
  • pmid:22684091
ISSN
1432-1041
DOI
10.1007/s00228-012-1322-6
language
English
LU publication?
yes
id
94cead24-2335-4c91-9527-3bc849ca17ab (old id 3591079)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22684091
date added to LUP
2016-04-01 13:23:07
date last changed
2022-03-21 18:18:32
@article{94cead24-2335-4c91-9527-3bc849ca17ab,
  abstract     = {{Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden. The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors' adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e., congestive heart failure, hypertension, age > 75 years, diabetes, previous stroke and transient ischemic attack. Data were obtained from primary health care records that contained individual clinical data. In total, 371,036 patients were included in the sample from 2002, and 424,329 patients were included in the sample from 2007. The study population consisted of individuals aged 45+ years who were diagnosed with AF in 2002 (1,330 men and 1,096 women) and 2007 (2,748 men and 2,234 women). The pharmacotherapies prescribed in 2002 and 2007 were analyzed separately in men and women. Logistic regression was used to calculate the association between the CHADS2 score and prescribed warfarin treatment. Selective beta-blockers, anti-coagulant therapy and lipid-lowering drugs were prescribed more frequently in 2007 than in 2002. In 2007, antithrombotic and RAS-blocking agents were prescribed more frequently to men, whereas beta-1 selective beta-blockers were prescribed more frequently to women. There was no consistent association between the CHADS2 score and prescribed warfarin treatment. Pharmacotherapy of AF has improved over time, though CHADS2 guidelines need to be implemented systematically in primary health care in Sweden to decrease the risk of stroke and improve quality of life in patients with AF.}},
  author       = {{Carlsson, Axel C. and Wandell, Per and Sundquist, Kristina and Johansson, Sven-Erik and Sundquist, Jan}},
  issn         = {{1432-1041}},
  keywords     = {{Atrial fibrillation; Pharmacotherapy; Gender; Warfarin; CHADS2; Sweden}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{245--253}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Pharmacology}},
  title        = {{Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors' adherence to warfarin therapy recommendations}},
  url          = {{http://dx.doi.org/10.1007/s00228-012-1322-6}},
  doi          = {{10.1007/s00228-012-1322-6}},
  volume       = {{69}},
  year         = {{2013}},
}