Observational studyBMJ open2021
Socioeconomic inequality in oral anticoagulation therapy initiation in patients with atrial fibrillation with high risk of stroke: a register-based observational study.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Not all cost conversations are the same: An exploration of potential value in cost conversations during Atrial fibrillation treatment decision making.Patient education and counseling · 2024Trial
- Association of Neighbourhood Deprivation with Secondary Prevention Prescribing and All-Cause Mortality among Stroke Patients in Scotland: A Population-Based Study.Cerebrovascular diseases (Basel, Switzerland) · 2026Observational
- Temporal trends in associations between social drivers and life-years lost in newly diagnosed atrial fibrillation in Denmark, 2000-22: a nationwide cohort study.The Lancet. Public health · 2026Article
- Clinical complexity in patients with atrial fibrillation: exploring differential risk profiles from European and Asian cohorts.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Management of anticoagulation in patients with atrial fibrillation and renal dysfunction: A systematic review.World journal of experimental medicine · 2025Article
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- General practice-related variation in oral anticoagulant treatment of atrial fibrillation: a nationwide cohort study.BJGP open · 2025Article
- Social drivers in atrial fibrillation occurrence, screening, treatment, and outcomes: systematic-narrative hybrid review.European heart journal supplements : journal of the European Society of Cardiology · 2024Article
- Social determinants of health and clinical outcomes among patients with atrial fibrillation: evidence from a global federated health research network.QJM : monthly journal of the Association of Physicians · 2024Article
- Oral anticoagulation therapy initiation in patients with atrial fibrillation in relation to world region of origin: a register-based nationwide study.Open heart · 2024Article
- COVID-19 pandemic and initiation of treatment for atrial fibrillation: a nationwide analysis of claims data.BMC cardiovascular disorders · 2023Article
- Reimbursement and use of oral anticoagulants during 2014-2022 - A register-based study.Exploratory research in clinical and social pharmacy · 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
- Association of income and educational levels on initiation of oral anticoagulant therapy in patients with incident atrial fibrillation: A Finnish nationwide cohort study.British journal of clinical pharmacology · 2023Article
- Time trends in antithrombotic therapy prescription patterns: Real-world monocentric study in hospitalized patients with atrial fibrillation.World journal of cardiology · 2022Article
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- Disparities in oral anticoagulation initiation in patients with schizophrenia and atrial fibrillation: A nationwide cohort study.British journal of clinical pharmacology · 2022Article
- Socioeconomic disparities in use of rhythm control therapies in patients with incident atrial fibrillation: A Finnish nationwide cohort study.International journal of cardiology. Heart & vasculature · 2022Article
- Income and outcomes of patients with incident atrial fibrillation.Journal of epidemiology and community health · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe study aimed to examine the association between socioeconomic factors (SEFs) and oral anticoagulation (OAC) therapy and whether it was influenced by changing guidelines. We hypothesised that inequities in initiation of OAC reduced over time as more detailed and explicit clinical guidelines were issued.
designRegister-based observational study. SETTINGS: All Danish patients with an incident hospital diagnosis of atrial fibrillation (AF), aged ≥30 years old and with high risk of stroke from 1 May 1999 to 2 October 2015 were included. Absolute risk differences (RD) (95% CI) were used to measure the association.
participants154 448 patients (mean age 78.2 years, men 47.3%). EXPOSURE: Education, family income and cohabiting status were the SEFs used as exposure. OUTCOME: A prescription of OAC within -30 to +90 days of baseline (incident AF).
resultsDuring 2002-2007, the crude RD of initiation of OAC for men with high education was 14.9% (12.8 to 16.9). Inequality reduced when new guidelines were published, and in 2013-2016 the crude RD was 5.6% (3.5 to 7.7). After adjusting for age, the RD substantially reduced. The same pattern was seen for cohabiting status, while inequality was smaller and more constant for income.
conclusionPatients with low income, low education and living alone were associated with lower chance of being initiated with OAC. For education and cohabiting status, the crude difference reduced around 2011, when more detailed clinical guidelines were implemented in Denmark. Our results indicate that new guidelines might reduce inequality in OAC initiation and that new, high-cost drugs increase inequality.
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