Evidence map›Paper›PMID 37014881›Full record

Observational studyPloS one2023

Medico-economic comparison of two anticoagulant treatment strategies: Vitamin K antagonists vs. direct oral anticoagulants in older adults in nursing homes in France. The "MIKADO" study.

George Pisica-Donose, Matthieu Piccoli, Bastien Genet, Stéphane Bouee, Stefan Berechet, Ion Berechet, Antonin Dacasa Cortes, Sabri Atsamena, Catherine Bayle, Mihai Badescu and 8 more

Erratum issuedOpen access · goldAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 46% 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.

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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 3 institutions in 1 country.

George Pisica-DonoseMedalice, Le Port Marly, France.
Matthieu PiccoliMemory Resource and Research Centre of de Paris-Broca-Ile de France, Hopital Broca, APHP, Paris, France.ORCID 0000-0003-2189-8959
Bastien GenetMemory Resource and Research Centre of de Paris-Broca-Ile de France, Hopital Broca, APHP, Paris, France.
Stéphane BoueeCEMKA, Bourg-la-Reine, France.
Stefan BerechetSISPIA, Vincennes, France.
Ion BerechetSISPIA, Vincennes, France.
Antonin Dacasa CortesDomusVi, Suresnes, France.
Sabri AtsamenaEHPAD La Résidence de Ballancourt, Ballancourt-sur-Essonne, France.
Catherine BayleMemory Resource and Research Centre of de Paris-Broca-Ile de France, Hopital Broca, APHP, Paris, France.
Mihai BadescuEHPAD Fondation Condé, Chantilly, France.
François CatelainEHPAD Richard, Conflans-Sainte-Honorine, France.
Lynda KermecheEHPAD La Gentilhommière, Boussy-Saint-Antoine, France.
Isabelle MerlierEHPAD Centre Hospitalier de Brie Comte Robert, Brie-Comte-Robert, France.
Sahondranirina RakotoniaryEHPAD La Martinière, Sablé-sur-Sarthe, France.
Valérie SavinEHPAD Centre Hospitalier de la Mauldre, Jouars-Pontchartrain, France.
Ariane VidalEHPAD Résidence Baccarat, Baccarat, France.
Jean-Sébastien VidalMemory Resource and Research Centre of de Paris-Broca-Ile de France, Hopital Broca, APHP, Paris, France.ORCID 0000-0001-6770-0720
Olivier HanonMemory Resource and Research Centre of de Paris-Broca-Ile de France, Hopital Broca, APHP, Paris, France.
Université Paris Cité · FRSociété Française d'Exportation des Ressources Éducatives · FRCemka-Eval (France) · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCurrently, two classes of oral anticoagulants are available in nursing home residents: vitamin K antagonists (VKA) and direct oral anticoagulants (DOAC). DOACs have a higher net clinical benefit than VKAs but DOACs are about 10 times more expensive than VKAs. The objective of our study was to assess and compare the overall costs of anti-coagulant strategy (VKA or DOAC), i.e., including drugs, laboratory costs and time spent in human capital (nurses and medical time) in nursing homes in France.

methodsThis was an observational, multicenter, prospective study including nine nursing homes in France. Among these nursing homes, 241 patients aged 75 years and older and treated with VKA (n = 140) or DOAC (n = 101) therapy accepted to participate in the study.

resultsDuring the 3-month follow-up period, the adjusted mean costs per patient were higher for VKA than DOACs for nurse care (€327 (57) vs. €154 (56), p<.0001) for general practitioner care (€297 (91) vs. €204 (91), p = 0.02), for coordinating physicians care (€13 (7) vs. €5 (7), p < 0.07), for laboratory tests (€23 (5) vs. €5 (5), p<.0001), but were lower for drug costs (€8 (3) vs. €165 (3), p<.0001). The average overall cost for 3 months per patient was €668 (140) with VKA vs. €533 (139) with DOAC (p = 0.02).

conclusionOur study showed that in nursing homes despite a higher drug cost, DOAC therapy is associated with a lower total cost and less time used by nurses and physicians for drug monitoring when compared to VKA.

Indexed as

AnticoagulantsNursing HomesAdministration, OralAgedFibrinolytic AgentsHumansProspective StudiesVitamin KAnticoagulantsFibrinolytic AgentsVitamin K

Identifiers

PMID37014881
PMCPMC10072791
OpenAlexW4362523375

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.