Why the study?
Does the locale of diagnosis (outpatient vs. hospital) affect oral anticoagulation uptake and adherence in patients with incident atrial fibrillation at high stroke risk?
Does the locale of diagnosis (outpatient vs. hospital) affect oral anticoagulation uptake and adherence in patients with incident atrial fibrillation at high stroke risk?
Outpatient diagnosis of atrial fibrillation is associated with higher rates of oral anticoagulation uptake and adherence compared to hospital diagnosis, highlighting the need for setting-specific interventions to improve stroke prevention.
May warrant setting-specific strategies to improve hospital OAC uptake; leaves open causal effects on adherence.
values for trend <0.0001). Warfarin control was 40.3% overall and remained unchanged. In multivariable analysis, outpatient diagnosis compared with the hospital was associated with greater OAC uptake (odds ratio [OR], 1.79; [95% CI, 1.72-1.87]) and direct OAC (OR, 1.42; [95% CI, 1.27-1.59]) and warfarin (OR, 1.49; [95% CI, 1.36-1.63]) adherence. Varying or persistently low adherence was associated with a poor prognosis, especially for warfarin. Conclusions Locale of nonvalvular atrial fibrillation diagnosis is associated with varying OAC uptake and adherence. Interventions specific to health care settings are needed to improve stroke prevention.
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Yogasundaram et al. (2022) studied this question.
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