Key result
Warfarin use in primary care shows a ~0.67% prevalence, driven primarily by chronic AF.
Why the study?
The indications for warfarin treatment in primary health care are increasing, and undertreatment in embolic stroke prevention in chronic atrial fibrillation patients has been reported, with suspected undertreatment for other indications.
Observational (n=75,146)
Yes
Warfarin treatment in Swedish primary care is prevalent, especially among the elderly and men, with chronic atrial fibrillation being the most common indication.
Warfarin use in Swedish primary care warrants monitoring in elderly men; extends real-world prevalence data but leaves optimal strategies open.
BACKGROUND: The indications for warfarin treatment in primary health care are increasing. An undertreatment with warfarin is reported in the prevention of embolic stroke in patients with chronic atrial fibrillation, and can be suspected for other indications. Information on the prevalence and incidence of diseases treated with warfarin would reveal useful data for audits concerning management of anticoagulant treatment. We aimed to assess warfarin treatment in primary health care with regard to prevalence, incidence, treatment diagnosis and patient characteristics. METHODS: A one-year retrospective study of electronic patient records up to May 2000 in primary health care in Stockholm, Sweden. Five primary health care centres with a registered population of 75 146. Main outcome measures were prevalence, incidence and treatment diagnosis. RESULTS: Five hundred and seven patients, mean age 71.9 years, were on warfarin treatment. The prevalence was 0.67% (age-adjusted 0.75%), and it was significantly higher for men (0.78%) than for women (0.58%) (p = 0.01). In the age group 75-84 years the prevalence was 4.54%. The most prevalent treatment diagnosis was chronic atrial fibrillation (0.28%), which was more predominant for males (p = 0.02), followed by cerebrovascular disease (0.13%) and deep venous thrombosis (0.13%). The yearly incidence of warfarin treatment was 0.17%, with chronic atrial fibrillation as the predominant treatment diagnosis. CONCLUSION: Warfarin treatment in primary health care is prevalent among the elderly. Chronic atrial fibrillation is the main treatment diagnosis. There is a gender difference favouring men in general and chronic atrial fibrillation as the treatment diagnosis.
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Nilsson et al. (2003) conducted an observational in Indications for anticoagulant treatment (e.g., chronic atrial fibrillation) (n=75,146). Warfarin treatment was evaluated on Prevalence of warfarin treatment. Warfarin treatment in primary health care had an overall prevalence of 0.67%, with chronic atrial fibrillation being the most common treatment diagnosis (0.28%).
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