Discontinuation and primary care visits in nonvalvular atrial fibrillation patients treated with apixaban or warfarin. (8th February 2019)

• Record Type: Journal Article
• Authors: Ramagopalan, Sreeram V; Graham, Sophie; Carroll, Robert; Raluy-Callado, Mireia; Nordstrom, Beth L; Donaldson, Robert; Colby, Chris; Mehmud, Faisal; Alikhan, Raza
• Is Part Of: Journal of comparative effectiveness research. Volume 8:Number 6(2019)
• Page Start: 371
• Page End: 379
• Publication Date: 2019-02-08
• Subjects: NVAF -- oral anticoagulants -- treatment persistence; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer-2019-0005
• Languages: English
• ISSNs: 2042-6305

Abstract

Aim: Nonvalvular atrial fibrillation (NVAF) requires long-term anticoagulation treatment, which may necessitate frequent primary care visits.Materials & methods: NVAF patients initiating warfarin or apixaban in 2012–2017 were identified from linked primary (Clinical Practice Research Datalink) and secondary care (Hospital Episode Statistics) data. A propensity score matched Cox regression model compared discontinuation risk. Primary care visits were compared via negative binomial regression.Results: A total of 2695 apixaban users were matched to warfarin patients. Discontinuation risk was lower with apixaban than warfarin (hazard ratio: 0.40; 95% CI: 0.35–0.46). Apixaban patients averaged 12.2 annual primary care visits, versus 17.1 for warfarin users (p < 0.001).Conclusion: Apixaban was associated with reduced rates of discontinuation and primary care visits compared with warfarin.