Key result
Anticoagulants were overutilized in patients at low risk of stroke and underutilized in patients at higher risk, with usage decreasing as HAS-BLED scores increased.
Why the study?
What are the utilization patterns of antithrombotic therapy in older Australians with atrial fibrillation based on stroke and bleeding risk?
Observational
What are the utilization patterns of antithrombotic therapy in older Australians with atrial fibrillation based on stroke and bleeding risk?
In older Australians with atrial fibrillation, oral anticoagulants are frequently misallocated, being overutilized in low-risk patients and underutilized in high-risk patients, largely driven by perceived bleeding risk.
Anticoagulant underuse in high-stroke-risk AF and overuse in low-risk patients persists in Australia; leaves open optimal risk-stratification strategies for practice.
What is known and Objective: Oral anticoagulants are essential drugs for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Anticoagulants are, however, commonly withheld due to a perceived risk of severe adverse events. The underutilization of anticoagulants in patients with AF has been demonstrated internationally, but to date, there are limited data available in the Australian context. The aim of this study was to determine the utilization patterns of anticoagulants (including novel oral anticoagulants) with respect to stroke and bleeding risk among patients with AF within the community. Methods: We performed a nonexperimental, retrospective analysis designed to evaluate antithrombotic usage for AF in Australia. The utilization of antithrombotic therapy and the appropriateness of therapy were determined based on CHADS2, CHA2DS2-VASc and HAS-BLED risk stratification schemes. The presence of documented contraindications was used to determine the appropriateness of antithrombotic therapy. What is new and Conclusion: Anticoagulants were overutilized in patients at low risk of stroke and underutilized in patients at higher risk of stroke. As the HAS-BLED score increased, the likelihood of patients receiving an anticoagulant decreased regardless of CHADS 2 or CHA 2 DS 2 -VASc scores.
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Frain et al. (2016) conducted an observational in Atrial Fibrillation. Anticoagulants was evaluated on Utilization patterns of anticoagulants with respect to stroke and bleeding risk. Anticoagulants were overutilized in patients at low risk of stroke and underutilized in patients at higher risk, with usage decreasing as HAS-BLED scores increased.