Evidence map›Paper›PMID 28384199›Full record

ArticlePloS one2017

Areas of improvement in anticoagulant safety. Data from the CACAO study, a cohort in general practice.

Paul Frappé, Joël Cogneau, Yoann Gaboreau, Nathan Abenhaïm, Marc Bayen, Matthieu Calafiore, Claude Guichard, Jean-Pierre Jacquet, François Lacoin, Laurent Bertoletti and 1 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02376777 (Comparison of Accidents and Their Circumstances With Oral Anticoagulants. The CACAO Study), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02376777 completednot on this map

Comparison of Accidents and Their Circumstances With Oral Anticoagulants. The CACAO Study

TypeobservationalSponsorCNGE IRMG AssociationRan2014 to 2017Enrolled4,162ConditionsCardiovascular Complications, Hemorrhagic Disorders, Embolism and ThrombosisArmsFollow up
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Paul FrappéDepartment of General Practice, University of Saint-Etienne, Saint-Etienne, France.ORCID http://orcid.org/0000-0002-7350-2824
Joël CogneauInstitut de Recherche en Médecine Générale, Paris, France.
Yoann GaboreauDepartment of General Practice, Grenoble Alpes University, Grenoble, France.
Nathan AbenhaïmInstitut de Recherche en Médecine Générale, Paris, France.
Marc BayenDepartment of General Practice, University of Lille, Lille, France.
Matthieu CalafioreDepartment of General Practice, University of Lille, Lille, France.
Claude GuichardInstitut de Recherche en Médecine Générale, Paris, France.
Jean-Pierre JacquetDepartment of General Practice, Grenoble Alpes University, Grenoble, France.
François LacoinInstitut de Recherche en Médecine Générale, Paris, France.
Laurent BertolettiInserm U 1059, Sainbiose DVH, University of Saint-Etienne, Saint-Etienne, France.
CACAO study investigators
Inserm · FRUniversité de Lille · FRTranslational Innovation in Medicine and Complexity · FRUniversité Grenoble Alpes · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReal-world studies on anticoagulants are mostly performed on health insurance databases, limited to reported events, and sometimes far from every-day issues in family practice. We assess the presence of data for safe monitoring of oral anticoagulants in general practice, and compare patients' knowledge of taking an anticoagulant between vitamin K antagonists (VKA) and direct anticoagulants (DOAC), and the general practitioner's perception of their adherence to anticoagulation.

methodsThe CACAO study is a national cohort study, conducted by general practitioners on ambulatory patients under oral anticoagulant. In the first phase, investigators provided safety data available from medical records at inclusion. They also evaluated patients' knowledge about anticoagulation and graded their perception of patients' adherence.

resultsBetween April and December 2014, 463 general practitioners included 7154 patients. Renal and hepatic function tests were respectively unavailable in 109 (7.5%) and 359 (24.7%) DOAC patients. Among patients with atrial fibrillation, 345 patients (6.9%) had a questionable indication of anticoagulant (CHA2DS2-Vasc<2). One hundred and thirty-three VKA patients (2.3%) and 70 DOAC patients (4.9%) answered they took no anticoagulant (p<0.0001). According to general practitioners' perception, 430 patients (6.1%) were classified as "not very" or "not adherent", with no difference between groups.

conclusionsOur results highlight the efforts needed to improve anticoagulant safety in daily practice: decreasing the rate of unknown biological data in patients with DOACs or the rate of patients with VKA with no strong indication of anticoagulation, and improving patient knowledge with regard to their anticoagulant. Patients' adherence seems highly over-estimated by the general practitioners. CLINICAL

trial registrationClinicalTrials.gov NCT02376777.

Indexed as

AgedAged, 80 and overAnticoagulantsCohort StudiesFemaleHumansMaleAnticoagulants

Identifiers

PMID28384199
PMCPMC5383059
OpenAlexW2604695975

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.