Observational studyJournal of the American Medical Directors Association2026
Oral Anticoagulant Use Among Residents in VA Long-Term Care With Atrial Fibrillation After the 2014 ACC/AHA Guideline.
Observational study in Journal of the American Medical Directors Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectivesIn 2014, the American College of Cardiology/American Heart Association moved away from recommending aspirin in atrial fibrillation (AF) and recommended that patients be treated with oral anticoagulants (OACs) to mitigate the risk of stroke. We aimed to evaluate the prevalence and predictors of OACs and/or aspirin use among veterans with AF in Veterans Affairs nursing homes in the era after the guideline publication.
designObservational study of veterans admitted from October 1, 2014 to September 30, 2019. SETTING AND
participantsFour thousand nine hundred ninety-four nursing home residents with AF and a CHA
methodsMultinomial logistic regression was used to compare demographics, comorbidities, functional status, and concurrent antiplatelet medication use in residents who received OAC ± aspirin and aspirin alone, compared with neither.
resultsIn the era after the 2014 American College of Cardiology/American Heart Association guideline was released, age-standardized prevalence rates for any OAC (warfarin and direct oral anticoagulant) increased from 31.2% in fiscal year (FY) 2013 to 2014 to 46.6% in FY 2019. In addition, there was a decrease in patients receiving no OAC (21.1%-16.2%) and aspirin (47.7%-39.3%). However, some eligible residents remained untreated. Averaged over FY 2015 to 2019, each decade of ascending age was associated with a lower likelihood of receiving OAC [relative risk ratio (RRR), 0.79; 95% CI, 0.71-0.87], relative to neither anticoagulant nor aspirin use. Black veterans were less likely to receive OAC (RRR, 0.73; 95% CI, 0.58-0.91); Hispanic veterans were less likely to receive OAC (RRR, 0.63; 95% CI, 0.44-0.91) and aspirin (RRR, 0.47; 95% CI, 0.31-0.72). Mild to moderate cognitive impairment, greater disability, and other antiplatelet use were also associated with less OAC use. CONCLUSIONS AND IMPLICATIONS: Fewer Veterans Affairs nursing home residents received OACs than recommended by guidelines, with significant differences by age and race/ethnicity. Future research efforts should aim to understand the reasons for low OAC use and to augment the evidence base for anticoagulant use to include frail older adults.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.