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July 10, 2026BMC GeriatricsOpen Access

Disparities in anticoagulation therapy for older adults with non-valvular atrial fibrillation: a comparative study of urban and suburban communities

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Why the study?

Real-world data on anticoagulation management for non-valvular atrial fibrillation at the primary care level remain sparse, particularly regarding disparities between urban and suburban populations.

Does urban versus suburban residence affect anticoagulation utilization and medication-dispensing patterns in older adults with non-valvular atrial fibrillation?

Population

302 older patients with NVAF across four community health centers in Shanghai, China

Comparison

Urban vs suburban community cohorts

Design

Stratified cross-sectional study

Key result

Among older adults with non-valvular atrial fibrillation at high risk for stroke, the overall anticoagulation utilization rate was 30.5%, with no significant difference between urban and suburban communities.

Authors

YDYuanxia DuanZPZhigang PanJGJie Gu

Discussion

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Member takes

Overview

Disparities in anticoagulation for urban vs suburban older adults with AF warrant equity-focused attention; cross-sectional data leaves open causes and outcome effects.

Key Points

  • This study aims to evaluate the disparities in anticoagulation therapy among older adults with non-valvular atrial fibrillation in urban versus suburban settings.
  • Stratified cross-sectional study conducted in four community health centers in Shanghai, China.
  • Included 302 older adults diagnosed with atrial fibrillation during routine health check-ups in 2020.
  • Multivariable logistic regression analysis to explore factors influencing medication-dispensing locations.
  • Prevalence of thromboembolic events was 14.9% and bleeding complications 3.6%.
  • Urban NVAF patients had a higher prevalence of diabetes and stroke risk compared to suburban patients (p < 0.05).
  • 49.4% of patients receiving anticoagulation sourced their medications from community health centers.

Study Design

Type

Cross-Sectional (n=302)

Multicenter

Yes

Structured PICO

Does urban versus suburban residence affect anticoagulation utilization and medication-dispensing patterns in older adults with non-valvular atrial fibrillation?

P
Population
302 older adults (aged ≥65 years) with non-valvular atrial fibrillation undergoing community health examinations in Shanghai, China, were evaluated for anticoagulation therapy utilization.
E
Exposure
Urban community residence
C
Comparator
Suburban community residence
O
Outcome
Anticoagulant utilization and medication-dispensing patterns

Main Result

p-value: p=>0.05

Anticoagulation management for older NVAF patients in Chinese community settings remains suboptimal, with no significant disparity in standardized treatment rates between urban and suburban high-risk patients.

Limitations

  • Selection bias as participants were drawn from voluntary health check-ups
  • Comorbidity data were initially self-reported
  • Survival bias (immortal time bias) due to identifying the cohort in 2020 and interviewing in 2022
  • Cross-sectional design precludes assessment of longitudinal mortality data

Cite This Study

Duan et al. (2026) conducted a cross-sectional in Non-valvular atrial fibrillation (n=302). Urban community setting vs. Suburban community setting was evaluated on Overall prevalence of anticoagulant utilization among high-risk patients (p=>0.05). Among older adults with non-valvular atrial fibrillation at high risk for stroke, the overall anticoagulation utilization rate was 30.5%, with no significant difference between urban and suburban communities.

synapsesocial.com/papers/6a508ea56eeac72a437a15c7https://doi.org/10.1186/s12877-026-07935-4
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