ArticleAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2022
Direct Oral Anticoagulants and Warfarin for Atrial Fibrillation Treatment: Rural and Urban Trends in Medicare Beneficiaries.
Article in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Care for Atrial Fibrillation and Outcomes in Rural Versus Urban Communities in the United States: A Systematic and Narrative Review.Journal of the American Heart Association · 2025Pooled it
- Trends in United States mortality among patients with atrial fibrillation/flutter related heart failure (1999-2024): disparities by gender, race/ethnicity and region.BMC cardiovascular disorders · 2025Article
- Evaluation of gaps in direct oral anticoagulants (DOACs) management in an outpatient underserved clinic: a cross-sectional study.Scientific reports · 2025Article
- Atrial fibrillation in the Americas.Lancet regional health. Americas · 2025Review
- Trends in Mortality Related to Atrial Fibrillation and Dementia in Older Adults in the United States: A 2000-2020 Analysis.Journal of cardiovascular electrophysiology · 2025Article
- Neighborhood characteristics and outcomes in patients with atrial fibrillation: A large cohort study in the Midwest.Heart rhythm O2 · 2025Article
- Rural-Urban Disparities in the Uptake of New Diabetes Medications.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Disparities in the real-world prescription pattern of oral anticoagulants for US Medicare beneficiaries: a geospatial analysis.BMJ open · 2024Article
- Rurality and Atrial Fibrillation: Patient Perceptions of Barriers and Facilitators to Care.Journal of the American Heart Association · 2023Article
- Initiation of oral anticoagulation in US older adults newly diagnosed with atrial fibrillation during hospitalization.Journal of the American Geriatrics Society · 2023Article
- Insertable cardiac monitoring results in higher rates of atrial fibrillation diagnosis and oral anticoagulation prescription after ischaemic stroke.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 · 2023Article
- Anticoagulation under-utilization in atrial fibrillation patients is responsible for a large proportion of strokes requiring endovascular therapy.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Article
- Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report.JAMA cardiology · 2023Article
- A retrospective comparison of the emergent use of fixed-dose four-factor prothrombin complex versus weight-based dosing for intracranial hemorrhage assessing medication delivery time and cost.International journal of physiology, pathophysiology and pharmacology · 2023Article
- Trends in Use of Oral Anticoagulants in Older Adults With Newly Diagnosed Atrial Fibrillation, 2010-2020.JAMA network open · 2022Article
- Article
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8 authors.
Funding
Abstract
backgroundData are needed on the use of oral anticoagulation in patients with atrial fibrillation (AF) in rural versus urban areas, including the initiation of direct oral anticoagulants (DOACs).
objectiveWe used Medicare data to examine rural/urban differences in anticoagulation use in patients with AF.
methodsWe identified incident AF in a 20% sample of fee-for-service Medicare beneficiaries (aged ≥ 65 years) from 2011 to 2016 and collected ZIP code and covariates at the time of AF. We identified the first anticoagulant prescription filled, if any, following AF diagnosis. We categorized beneficiaries into four rural/urban areas using rural-urban commuting area codes and used Poisson regression models to compare anticoagulant use.
resultsWe included 447,252 patients with AF (mean age 79 ± 8 years), of which 82% were urban, 9% large rural, 5% small rural, and 4% isolated. The percentage who initiated an anticoagulant rose from 34% in 2011 to 53% in 2016, paralleling the uptake of DOACs. In a multivariable-adjusted analysis, those in rural areas (vs. urban) were more likely to initiate an anticoagulant. However, rural beneficiaries (vs. urban) were less likely to initiate a DOAC; those in isolated areas were 17% less likely (95% confidence interval [CI] 13-20), those in small rural areas were 12% less likely (95% CI 9-15), and those in large rural areas were 10% less likely (95% CI 8-12).
conclusionAmong Medicare beneficiaries with AF, anticoagulation use was low but increased over time with the introduction of DOACs. Rural beneficiaries were less likely to receive a DOAC.
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