Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation

Alexander Birkinshaw; Chris H Fry; David Fluck; Pankaj Sharma; Thang S Han

doi:10.1177/2048004020915406

Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation

Alexander Birkinshaw, Chris H Fry, David Fluck, Pankaj Sharma, Thang S Han^*

^*Corresponding author for this work

School of Physiology, Pharmacology & Neuroscience

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Background: Prevention of thromboembolism by novel anticoagulants (NOACs) is increasing, whilst use of vitamin K antagonists (VKAs) is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular AF (NVAF) between 2014 and 2018.
Methods: 162 consecutive patients (95 men, 67 women) with NVAF, mean age 72.3yrs (SD=11.0), underwent cardiac assessment in a single Cardiac Unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed NOACs and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change (AAPC) using a Joinpoint Regression Program 4.7.0.0.
Results: There were diverging trends in anticoagulant treatment from 2014-2018 without join-points: yearly increase in NOAC treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, AAPC = 16.2%, 95% CI = 5.8% to 27.5%, p <0.001), and decrease in warfarin treatment (57.1, 54.5, 46.3, 46.9 and 27.3%, AAPC = -14.4%, 95% CI = -25.2% to -2.1%, p <0.001).
Conclusions: Changing trends in treatment with anticoagulants for patients with NVAF observed within less than two years provides important information to healthcare services to estimate future pharmaco-economic costs for such treatments.

Original language	English
Number of pages	5
Journal	JRSM Cardiovascular Disease
Early online date	29 Mar 2020
DOIs	https://doi.org/10.1177/2048004020915406
Publication status	E-pub ahead of print - 29 Mar 2020

Keywords

Pharmaco-economics
thromboembolism;
vitamin K antagonists

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@article{ec368b4b956a4e0d8112a0bde7c024a0,

title = "Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation",

abstract = "Background: Prevention of thromboembolism by novel anticoagulants (NOACs) is increasing, whilst use of vitamin K antagonists (VKAs) is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular AF (NVAF) between 2014 and 2018.Methods: 162 consecutive patients (95 men, 67 women) with NVAF, mean age 72.3yrs (SD=11.0), underwent cardiac assessment in a single Cardiac Unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed NOACs and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change (AAPC) using a Joinpoint Regression Program 4.7.0.0.Results: There were diverging trends in anticoagulant treatment from 2014-2018 without join-points: yearly increase in NOAC treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, AAPC = 16.2%, 95% CI = 5.8% to 27.5%, p <0.001), and decrease in warfarin treatment (57.1, 54.5, 46.3, 46.9 and 27.3%, AAPC = -14.4%, 95% CI = -25.2% to -2.1%, p <0.001).Conclusions: Changing trends in treatment with anticoagulants for patients with NVAF observed within less than two years provides important information to healthcare services to estimate future pharmaco-economic costs for such treatments.",

keywords = "Pharmaco-economics, thromboembolism;, vitamin K antagonists",

author = "Alexander Birkinshaw and Fry, {Chris H} and David Fluck and Pankaj Sharma and Han, {Thang S}",

year = "2020",

month = mar,

day = "29",

doi = "10.1177/2048004020915406",

language = "English",

journal = "JRSM Cardiovascular Disease",

}

TY - JOUR

T1 - Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation

AU - Birkinshaw, Alexander

AU - Fry, Chris H

AU - Fluck, David

AU - Sharma, Pankaj

AU - Han, Thang S

PY - 2020/3/29

Y1 - 2020/3/29

N2 - Background: Prevention of thromboembolism by novel anticoagulants (NOACs) is increasing, whilst use of vitamin K antagonists (VKAs) is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular AF (NVAF) between 2014 and 2018.Methods: 162 consecutive patients (95 men, 67 women) with NVAF, mean age 72.3yrs (SD=11.0), underwent cardiac assessment in a single Cardiac Unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed NOACs and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change (AAPC) using a Joinpoint Regression Program 4.7.0.0.Results: There were diverging trends in anticoagulant treatment from 2014-2018 without join-points: yearly increase in NOAC treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, AAPC = 16.2%, 95% CI = 5.8% to 27.5%, p <0.001), and decrease in warfarin treatment (57.1, 54.5, 46.3, 46.9 and 27.3%, AAPC = -14.4%, 95% CI = -25.2% to -2.1%, p <0.001).Conclusions: Changing trends in treatment with anticoagulants for patients with NVAF observed within less than two years provides important information to healthcare services to estimate future pharmaco-economic costs for such treatments.

AB - Background: Prevention of thromboembolism by novel anticoagulants (NOACs) is increasing, whilst use of vitamin K antagonists (VKAs) is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular AF (NVAF) between 2014 and 2018.Methods: 162 consecutive patients (95 men, 67 women) with NVAF, mean age 72.3yrs (SD=11.0), underwent cardiac assessment in a single Cardiac Unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed NOACs and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change (AAPC) using a Joinpoint Regression Program 4.7.0.0.Results: There were diverging trends in anticoagulant treatment from 2014-2018 without join-points: yearly increase in NOAC treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, AAPC = 16.2%, 95% CI = 5.8% to 27.5%, p <0.001), and decrease in warfarin treatment (57.1, 54.5, 46.3, 46.9 and 27.3%, AAPC = -14.4%, 95% CI = -25.2% to -2.1%, p <0.001).Conclusions: Changing trends in treatment with anticoagulants for patients with NVAF observed within less than two years provides important information to healthcare services to estimate future pharmaco-economic costs for such treatments.

KW - Pharmaco-economics

KW - thromboembolism;

KW - vitamin K antagonists

U2 - 10.1177/2048004020915406

DO - 10.1177/2048004020915406

M3 - Article (Academic Journal)

C2 - 32284860

JO - JRSM Cardiovascular Disease

JF - JRSM Cardiovascular Disease

ER -