Observational studyJournal of the American Heart Association2019
Anticoagulant Prescribing for Non-Valvular Atrial Fibrillation in the Veterans Health Administration.
Observational study in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Economic Aspects of Service Interventions to Increase Anticoagulation Use in Atrial Fibrillation.Thrombosis and haemostasis · 2022Pooled it
- Prospective Monitoring of New Drugs in Older Adults with and without Frailty: Near-Real-Time Assessment of Effectiveness and Safety of Oral Anticoagulants in Medicare Data.Drugs & aging · 2024Article
- Anticoagulant therapy in renal insufficiency theme: Anticoagulation in complex situations.Thrombosis research · 2024Review
- Veterans Affairs Medical Center Racial and Ethnic Composition and Initiation of Anticoagulation for Atrial Fibrillation.JAMA network open · 2024Article
- Discriminating factors excluding patients from a catheter-based left atrial appendage closure and an outcome analysis of non-intervened and intervened patients.Archives of medical science : AMS · 2024Article
- Temporal trends in anticoagulation use and clinical outcomes among medicare beneficiaries with non-valvular atrial fibrillation.Journal of thrombosis and thrombolysis · 2024Article
- Response to Letter to the Editor regarding Factors associated with oral anticoagulant prescription status among patients with a new diagnosis of atrial fibrillation.Clinical cardiology · 2023Article
- Outcomes of recurrent stroke in patients with atrial fibrillation according to presumed etiology.Arquivos de neuro-psiquiatria · 2023Article
- Direct Oral Anticoagulants in the Very Elderly.Thrombosis and haemostasis · 2023Article
- Association of Neighborhood Disadvantage and Anticoagulation for Patients with Atrial Fibrillation in the Veterans Health Administration: the REACH-AF Study.Journal of general internal medicine · 2023Article
- Temporal trends in anticoagulation management for US active duty personnel with atrial fibrillation.BMJ open · 2022Article
- Outcomes in patients implanted with a Watchman device in relation to choice of anticoagulation and indication for implant.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Guideline-discordant dosing of direct-acting oral anticoagulants in the veterans health administration.BMC health services research · 2021Article
- Atrial fibrillation and clinical outcomes 1 to 3 years after myocardial infarction.Open heart · 2021Observational
- Outpatient and inpatient anticoagulation therapy and the risk for hospital admission and death among COVID-19 patients.EClinicalMedicine · 2021Article
- Factors associated with primary nonadherence to newly initiated direct oral anticoagulants in patients with nonvalvular atrial fibrillation.Journal of managed care & specialty pharmacy · 2021Observational
- Prescribing of direct oral anticoagulants and warfarin to older people with atrial fibrillation in UK general practice: a cohort study.BMC medicine · 2021Article
- Disparities in Anticoagulant Therapy Initiation for Incident Atrial Fibrillation by Race/Ethnicity Among Patients in the Veterans Health Administration System.JAMA network open · 2021Article
- Observational
- Direct Oral Anticoagulant Use in Special Populations: Elderly, Obesity, and Renal Failure.Current cardiology reports · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Background Direct acting oral anticoagulants (DOACs) theoretically could contribute to addressing underuse of anticoagulation in non-valvular atrial fibrillation (NVAF). Few studies have examined this prospect, however. The potential of DOACs to address underuse of anticoagulation in NVAF could be magnified within a healthcare system that sharply limits patients' exposure to out-of-pocket copayments, such as the Veterans Health Administration (VA). Methods and Results We used a clinical data set of all patients with NVAF treated within VA from 2007 to 2016 (n=987 373). We examined how the proportion of patients receiving any anticoagulation, and which agent was prescribed, changed over time. When first approved for VA use in 2011, DOACs constituted a tiny proportion of all prescriptions for anticoagulants (2%); by 2016, this proportion had increased to 45% of all prescriptions and 67% of new prescriptions. Patient characteristics associated with receiving a DOAC, rather than warfarin, included white race, better kidney function, fewer comorbid conditions overall, and no history of stroke or bleeding. In 2007, before the introduction of DOACs, 56% of VA patients with NVAF were receiving anticoagulation; this dipped to 44% in 2012 just after the introduction of DOACs and had risen back to 51% by 2016. Conclusions These results do not suggest that the availability of DOACs has led to an increased proportion of patients with NVAF receiving anticoagulation, even in the context of a healthcare system that sharply limits patients' exposure to out-of-pocket copayments.
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