Evidence map›Paper›PMID 30144015›Full record

ArticleAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2018

Healthcare Utilization and Expenditures in Working-Age Adults with Atrial Fibrillation: The Effect of Switching from Warfarin to Non-Vitamin K Oral Anticoagulants.

Xue Feng, Usha Sambamoorthi, Kim Innes, Traci LeMasters, Gregory Castelli, Nilanjana Dwibedi, Xi Tan

Abstract read
In one paragraph

Article in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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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

7 authors.

Xue FengDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Usha SambamoorthiDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Kim InnesDepartment of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA.
Traci LeMastersDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Gregory CastelliUniversity of Pittsburgh Medical Center (UPMC) St. Margaret, Pittsburgh, PA, USA.
Nilanjana DwibediDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Xi TanDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA. xntan@hsc.wvu.edu.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Laura F. Gibson · 2012 to 2026
$81.0M
National Institute of General Medical Sciences U54GM104942NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

objectiveOur objective was to evaluate the association between switching from warfarin to non-vitamin K oral anticoagulants (NOACs) and potential drug-drug interactions (DDIs), healthcare utilization, and expenditures in working-age adults with atrial fibrillation (AF).

methodsWe conducted a retrospective cohort study using data from 2010 to 2015 for patients who switched from warfarin to NOACs (switchers) and those who continued to receive warfarin (non-switchers). We identified medications known or suspected to have clinically significant interactions with NOACs or warfarin. We used multivariate logistic regression, negative binomial, and generalized linear models to evaluate the influence of switching to NOACs and of potential DDIs on inpatient visits, outpatient visits, number of outpatient visits, and non-drug medical expenditures. Inverse probability of treatment weighting was also applied in analyses.

resultsA total of 4126 patients with AF were included in the study. Switching to NOACs was significantly and negatively related to the number of outpatient, inpatient, and emergency room (ER) visits and non-drug medical expenditures. When potential DDIs were included in the models, switching remained significantly associated only with reduced inpatient and outpatient visits. Notably, having at least one potential DDI was associated with an increased likelihood of ER visits and the number of outpatient visits; it was also significantly and positively associated with non-drug medical expenditures.

conclusionsRelative to persistent warfarin use, switching to NOACs was associated with fewer inpatient, ER, and outpatient visits and lower non-drug costs. Potential DDIs were also strongly and positively associated with healthcare utilization and expenditures. Both are critical to consider in the management of AF in working-age adults.

Indexed as

Administration, OralAdolescentAdultAnticoagulantsAtrial FibrillationCost of IllnessDrug InteractionsFactor Xa InhibitorsFemaleHealth ExpendituresHealth ServicesHemorrhageHumansLogistic ModelsMaleMiddle AgedAnticoagulantsFactor Xa InhibitorsWarfarin

Identifiers

PMID30144015
PMCPMC6428195

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Registered trials

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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.