Key result
Larger general practice size is linked to higher rates of NOAC prescription initiation.
Why the study?
General practitioners prescribing of new oral anticoagulants in Ireland is complex due to pharmacokinetic characteristics and increasing use despite warfarin guidelines.
Cross-Sectional (n=221)
Effect estimate: Marginal effect 0.024
p-value: p=<0.05
Larger practices may shape OAC initiation patterns in primary care; leaves open whether practice-level factors drive guideline-concordant prescribing.
OBJECTIVE: New oral anticoagulants (NOACs) aim to overcome warfarin's shortcomings, however their pharmacokinetic characteristics make prescribing complex. Thus it is imperative that general practitioners (GPs) are aware of specific treatments so as to maximise their benefits and minimise their pitfalls. This study explores GPs attitudes and experiences with prescribing NOACs in Ireland where, despite clear national prescribing guidelines advocating warfarin as first line therapy, the number of patients being prescribed NOACs for the first time is growing. RESULTS: Using primary data collected from GPs in Ireland the factors influencing the likelihood of a GP initiating a prescription for a NOAC are determined using a probit model. Results indicate 46% of the sample initiated NOAC prescriptions and GP practice size is a significant factor influencing this. Analysis revealed no difference regarding the sources of information considered important amongst GPs when prescribing new drugs. However, there were differences in which factors were considered important when prescribing anticoagulants between initiating and non-initiating NOAC prescribers. The results of this study suggest better utilisation of existing information and education tools for GPs prescribing NOACs and managing NOAC patients is imperative, to ensure the right anticoagulant is prescribed for the right patient at the right time.
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Murphy et al. (2018) conducted a cross-sectional in Atrial fibrillation (NOAC prescribing) (n=221). GP practice size vs. Smaller practice size was evaluated on Initiation of NOAC prescriptions (Marginal effect 0.024, p=<0.05). Larger general practice size significantly increased the likelihood of a general practitioner initiating new oral anticoagulant prescriptions (marginal effect 0.024, p<0.05).
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