Key result
Oral anticoagulant use in long-term care residents increased from 12.2% in 2013 to 16.5% in 2019, driven by rising DOAC use even among patients with dementia or prior GI bleeds.
Why the study?
The study examined trends in oral anticoagulant use among older adults residing in long-term care facilities since the introduction of DOACs, including in individuals with high-risk comorbidities such as prior gastrointestinal bleed and dementia.
How has the prevalence of oral anticoagulant use changed over time among older adults residing in long-term care facilities?
How has the prevalence of oral anticoagulant use changed over time among older adults residing in long-term care facilities?
Answers are grounded in this paper and cite their sources.
The use of oral anticoagulants, particularly DOACs, has significantly increased among older adults in long-term care facilities from 2013 to 2019, including in high-risk patients with prior gastrointestinal bleeding or dementia.
Purpose To examine oral anticoagulant ( OAC ) use in older adults residing in long‐term care facilities ( LTCFs ) since direct OACs ( DOACs ) were introduced, including trends over time and in people with high‐risk comorbidities (prior gastrointestinal bleed and dementia). Methods A repeated cross‐sectional study using the Registry of Senior Australians National Historical Cohort was conducted and included individuals aged ≥ 65 years residing in LTCFs in Australia between 2013 and 2019. Yearly age‐ and sex‐adjusted prevalence of OACs and 95% confidence intervals (CIs) were estimated using generalised estimating equation (GEE) Poisson models and adjusted prevalence ratios (aPRs) were calculated to estimate trends. Results In 500 883 individuals, the prevalence of OAC use increased from 12.2% (95% CI 12.1–12.4) in 2013 to 16.5% (95% CI 16.4–16.7) in 2019 [aPR 1.05 (95% CI 1.05–1.05)]. This was driven by an increase in the use of DOACs, from 2.24% (95% CI 2.19–2.29) to 12.5% (95% CI 12.3–12.6) [aPR 1.25 (95% CI 1.25–1.26)]. Increases in OAC use were also observed in people with prior gastrointestinal bleed, from 12.9% (95% CI 11.8–13.9) to 17.1% (95% CI 16.2–17.9) [aPR 1.05 (95% CI 1.03–1.06)]. The use of OACs increased over the study period for people living with dementia from 9.93% to 12.8% [aPR 1.04 (95% CI 1.04–1.05)], and for people without dementia from 15.7% to 21.7% [aPR 1.06 (95% CI 1.06–1.06)]. Conclusions This population‐based study showed increasing use of OACs among residents of LTCFs, including in higher‐risk comorbidity groups, indicating growing confidence in the use of DOACs in these groups.
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Harrison et al. (2026) studied this question. Oral anticoagulant use in long-term care residents increased from 12.2% in 2013 to 16.5% in 2019, driven by rising DOAC use even among patients with dementia or prior GI bleeds.
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