Evidence map›Paper›PMID 40413044›Full record

ArticleBMJ open2025

Temporal trends and patient determinants of geographical variation in oral anticoagulant treatment of atrial fibrillation: a Danish nationwide cohort study in 2013-2022.

Ina Grønkjær Laugesen, Anders Prior, Flemming Bro, Anna Mygind, Erik Lerkevang Grove

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Sex differences in the initiation of antithrombotic therapy in patients with atrial fibrillation in Germany.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Article
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

5 authors.

Ina Grønkjær LaugesenDepartment of Public Health, Aarhus University, Aarhus, Denmark inalauge@ph.au.dk.ORCID http://orcid.org/0000-0002-1101-4032
Anders PriorDepartment of Public Health, Aarhus University, Aarhus, Denmark.ORCID http://orcid.org/0000-0003-4053-3701
Flemming BroDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Anna MygindDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Erik Lerkevang GroveDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark.ORCID http://orcid.org/0000-0002-1466-0865

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate temporal trends in the geographical variation in oral anticoagulant (OAC) treatment of patients with atrial fibrillation, to evaluate the extent to which regional differences in patient populations may explain this difference and to explore whether patient predictors of adherence may have a different impact across regions.

designRegister-based cohort study from 1 January 2013 to 31 December 2022.

settingThe study used data from nationwide health registers to explore differences in OAC adherence across the five administrative regions in Denmark.

participantsPatients with atrial fibrillation and a CHA OUTCOME: Population adherence to OAC treatment operationalised as the proportion of days covered (PDC).

resultsA continuous rise in overall adherence (PDC) from 53% to 78% was observed during the study period. Concurrently, the predominant treatment shifted from vitamin K antagonists to direct OACs with a preference for rivaroxaban and apixaban. The adherence variation between the highest-performing and lowest-performing regions decreased from 18% in 2013 to 9% in 2022, whereas the relative between-regions rankings remained unchanged. Applying multivariate Poisson models adjusting for patient demographics, health status and socioeconomic factors did not substantially change the inter-regional variations; this suggests that different compositions of patient populations cannot explain these variations. However, the impact of socioeconomic factors and comorbidities among patients was unequal across regions. In regions with the lowest overall adherence, a higher risk of non-adherence was seen among patients having mental health disorders, low income and living alone.

conclusionsThe geographical variation in OAC adherence decreased over time as the overall adherence improved. However, substantial variation remained.

Indexed as

AnticoagulantsAtrial FibrillationStrokeAdministration, OralAgedAged, 80 and overCohort StudiesDenmarkFemaleHumansMaleMiddle AgedPyrazolesPyridonesRegistriesRivaroxabanAnticoagulantsapixabanPyrazolesPyridonesRivaroxabanCARDIOLOGYEPIDEMIOLOGYMedication AdherenceObservational StudyQuality in health careThromboembolism

Identifiers

PMID40413044
PMCPMC12104909

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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.