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October 21, 2004BMC Cardiovascular DisordersOpen Access

The use of warfarin in veterans with atrial fibrillation

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Key result

Among ideal anticoagulation candidates with atrial fibrillation in a Veterans Affairs healthcare system, 97% of patients were prescribed warfarin.

Population

722 unique veterans with atrial fibrillation treated at the VA Connecticut Healthcare System. Outpatients…

Design

Cohort

Authors

DBDawn M. BravataRegenstrief InstituteKRKaren RosenbeckVA Connecticut Healthcare SystemSKSue KancirVA Connecticut Healthcare System

Discussion

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Overview

High VA warfarin use in eligible AF patients supports integrated care models; leaves open generalizability to other systems.

Study Design

Type

Cohort (n=722)

Multicenter

No

Structured PICO

P
Population
722 unique veterans (538 outpatients, 212 inpatients) with atrial fibrillation treated at the VA Connecticut Healthcare System. Outpatients: mean age 74.0, 98% men. Inpatients: mean age 72.9, 99.5% men.
I
Intervention
Warfarin prescription
O
Outcome
Rate of warfarin prescription in eligible patients with atrial fibrillation

Ideal anticoagulation candidates with atrial fibrillation within a VA healthcare system are prescribed warfarin at very high rates (92-98%), exceeding rates previously reported in private sector and Medicare populations.

Limitations

  • Findings may not be generalizable to other VA healthcare systems or to non-VA hospitals.
  • Results may not be generalizable to women with atrial fibrillation.
  • Outpatient cohort was obtained from a one-month sample, which may limit generalizability.
  • Unable to determine the specific reasons for why such a high rate of warfarin use was observed.
  • Retrospective chart review may not have identified patients prescribed warfarin by private practitioners.
  • Cohort was assembled using diagnosis codes rather than electrocardiographic data.
  • Findings from one VA healthcare system may not be generalizable to other VA or non-VA hospitals
  • May not be generalizable to women due to predominantly male veteran population
  • Retrospective chart review may have underestimated warfarin prescriptions by private practitioners
  • Cohort assembled using diagnosis codes rather than electrocardiographic data
  • Relatively small sample size compared to national administrative datasets

Cite This Study

Bravata et al. (2004) conducted a cohort in Atrial fibrillation (n=722). Warfarin was evaluated on Rate of warfarin prescription in eligible patients with atrial fibrillation. Among ideal anticoagulation candidates with atrial fibrillation in a Veterans Affairs healthcare system, 97% of patients were prescribed warfarin.

synapsesocial.com/papers/6a0f95da5725bbd5cc5fe23ahttps://doi.org/10.1186/1471-2261-4-18
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Warfarin Use Following Ischemic Stroke Among Medicare Patients With Atrial Fibrillation1998 · 88 citations
  2. 2Warfarin for Stroke Prevention Still Underused in Atrial Fibrillation2000 · 122 citations
  3. 3Quality of Anticoagulation Management Among Patients With Atrial Fibrillation2000 · 296 citations
  4. 4Which Acute Stroke Patients with Atrial Fibrillation are Prescribed Warfarin Therapy? Results from One-Year's Experience in Dundee2000 · 1 citations
  5. 5Predictors of Warfarin Use Among Ohio Medicaid Patients With New-Onset Nonvalvular Atrial Fibrillation2003 · 72 citations