Key result
The use of warfarin decreased from 82.3% in 2014 to 62.0% in 2016 as direct oral anticoagulant use increased, but warfarin use subsequently rebounded to 80.6% by 2018.
Why the study?
Given the distinct monitoring requirements, costs, and safety profiles of warfarin versus direct oral anticoagulants, this study was conducted to determine their utilization trends in patients with atrial fibrillation at a public hospital in Jakarta.
Observational (n=380)
No
Despite the introduction of direct oral anticoagulants, warfarin remains the predominant anticoagulant for atrial fibrillation in a public hospital in Jakarta, likely driven by cost and insurance formularies.
Fluctuating anticoagulant use highlights need for ongoing surveillance; leaves open drivers of warfarin rebound and outcome implications.
Treatments used in atrial fibrillation therapy, such as those of anticoagulants, consist of vitamin K antagonists (warfarin) and direct oral anticoagulants (dabigatran, apixaban, rivaroxaban, and edoxaban). The use of warfarin requires regular monitoring of prothrombin time (PT) and international normalised ratio (INR). The therapeutic dose range is narrow, but the price is cheaper. Oral anticoagulants are directed, the incidence of major bleeding is lower, ease of use, food and drug interactions are minor, the half-life is shorter, and there is a lack of laboratory monitoring needs. Based on this problem, researchers conducted a study to determine the trend of using warfarin and oral anticoagulants in patients with atrial fibrillation at a public hospital in Jakarta. This study uses a qualitative approach, with longitudinal methods and retrospective data using outpatient medical records for the period 2014 to 2018. The trend of using warfarin anticoagulants decreased from 82.3% in 2014 to 62% in 2016, while oral anticoagulants were reduced. Direct oral anticoagulants are rivaroxaban and dabigatran, which are more widely used than apixaban, and edoxaban; no data on their use has been obtained. The opposite was true from 2017 to 2018, when the use of warfarin increased and caused a decrease in the use of direct oral anticoagulants. This research is expected to contribute to various parties, both health practitioners and academics, in terms of selecting therapies for atrial fibrillation.
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Musnelina et al. (2023) conducted an observational in Atrial fibrillation (n=380). Direct oral anticoagulants and warfarin was evaluated on Trends in the use of warfarin and direct oral anticoagulants. The use of warfarin decreased from 82.3% in 2014 to 62.0% in 2016 as direct oral anticoagulant use increased, but warfarin use subsequently rebounded to 80.6% by 2018.
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