基层社区老年心房颤动患者抗凝治疗现状及影响因素分析

Q: What is the clinical evidence from this study?

Study design: Review. Population: Atrial fibrillation. Intervention: Anticoagulation therapy (warfarin and non-vitamin K antagonist oral anticoagulants). Primary outcome: Anticoagulation therapy utilization, adherence, and time in therapeutic range (TTR).

张丽霞

doi:10.37155/2661-4766-0807-33

January 1, 2026临床医学前沿Open Access

基层社区老年心房颤动患者抗凝治疗现状及影响因素分析

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Key Points

To review the current status of anticoagulation therapy, drug selection, adherence, and influencing factors among elderly patients with atrial fibrillation in primary care communities.
Narrative review and synthesis of domestic multi-center registries and community sampling surveys evaluating anticoagulation therapy in elderly primary care populations.
Investigation of barriers to anticoagulation implementation across four domains: patient characteristics, physician capabilities, healthcare facility conditions, and social support systems.
In community-dwelling elderly patients, warfarin is used in only 15%-25% and novel oral anticoagulants in 5%-15%, while 1-year treatment persistence is 50%-65% and declines to 30%-45% at 2-year follow-up.
Warfarin time in therapeutic range (TTR) reaches only 38.6% in primary healthcare institutions compared with 56.2% in tertiary hospitals, with only 40%-55% maintaining target INR between 2.0-3.0.
Treatment barriers include fear of bleeding in approximately 40% of patients, age-related disparities where patients aged 80 and older have ~20% lower anticoagulation coverage than those aged 60-69, and primary care physician guideline awareness of only 50%-60%.

Structured PICO

P

Population

Elderly patients with atrial fibrillation in Chinese primary care community settings.

E

Exposure

Oral anticoagulation therapy (warfarin and novel oral anticoagulants [NOACs]) combined with primary care management strategies (physician training, drug supply assurance, follow-up mechanisms, patient health education, community pharmacy services, and multidisciplinary collaboration)

O

Outcome

Anticoagulation therapy utilization rate, medication selection rationality, medication adherence, and treatment target achievement (INR 2.0-3.0 time in therapeutic range [TTR])

This narrative review highlights the suboptimal utilization, adherence, and target achievement of anticoagulation therapy among elderly patients with atrial fibrillation in Chinese primary care communities, proposing multidisciplinary and system-level interventions to improve stroke prevention.

Limitations

Narrative review without original primary clinical trial data or formal meta-analysis

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Implication

Underuse of anticoagulation in community elderly AF signals implementation gaps; leaves open whether targeted interventions improve adherence and TTR.

Abstract

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Cite This Study

张丽霞 (2026) conducted a review in Atrial fibrillation. Anticoagulation therapy (warfarin and non-vitamin K antagonist oral anticoagulants) was evaluated on Anticoagulation therapy utilization, adherence, and time in therapeutic range (TTR).

synapsesocial.com/papers/6af347c6bdf2424ebd04f8b7 https://doi.org/10.37155/2661-4766-0807-33

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基层社区老年心房颤动患者抗凝治疗现状及影响因素分析

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

基层社区老年心房颤动患者抗凝治疗现状及影响因素分析

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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