Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation

Paul T. Kocis, Guodong Liu, Dinara Makenbaeva, Jeffrey Trocio, Diana Velott, Jo Ann B. Trainer, Younos Abdulsattar, Marta I. Molina, Douglas Leslie

Research output: Contribution to journalArticle

Abstract

Background: Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice. Objective: The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily. Methods: Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day. Prescription medications, co-morbidities, and CHADS2 and CHA2DS2-VASc scores were evaluated. CHADS2 assesses the risk of stroke in NVAF patients with the following risk factors: Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and history of prior Stroke or transient ischemic attack. The CHA2DS2-VASc score adds the following risk factors to the CHADS2 score: Age 65–74 years, Vascular Disease, and Sex Category (Female). Results: Overall, 324,172 patients with NVAF with mean CHADS2 and CHA2DS2-VASc scores of 1.51 and 3.08, respectively, were included in the study. Of these patients, 299,716 (92.5 %) took chronic medications, with an average of 6.9 medications per patient, and 215,527 (66.5 % of all patients or 71.9 % of those taking chronic medications) took medications more than once per day. Conclusion: Use of chronic medications other than anticoagulants is common among patients with NVAF, and medications are typically taken multiple times per day. The average number of medications per patient and multiple therapeutic classes prescribed underscore the clinical complexity of NVAF patients. Hence, the choice of a once daily anticoagulant versus a more than once daily anticoagulant may be less relevant in a real world NVAF population in terms of a potential convenience benefit.

Original languageEnglish (US)
Pages (from-to)165-173
Number of pages9
JournalDrugs - Real World Outcomes
Volume3
Issue number2
DOIs
StatePublished - Jun 1 2016

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Atrial Fibrillation
Anticoagulants
Prescriptions
Stroke
Transient Ischemic Attack
National Health Programs
Vascular Diseases
Diabetes Mellitus
Heart Failure
Databases
Hypertension
Morbidity

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Kocis, Paul T. ; Liu, Guodong ; Makenbaeva, Dinara ; Trocio, Jeffrey ; Velott, Diana ; Trainer, Jo Ann B. ; Abdulsattar, Younos ; Molina, Marta I. ; Leslie, Douglas. / Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation. In: Drugs - Real World Outcomes. 2016 ; Vol. 3, No. 2. pp. 165-173.
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abstract = "Background: Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice. Objective: The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily. Methods: Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day. Prescription medications, co-morbidities, and CHADS2 and CHA2DS2-VASc scores were evaluated. CHADS2 assesses the risk of stroke in NVAF patients with the following risk factors: Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and history of prior Stroke or transient ischemic attack. The CHA2DS2-VASc score adds the following risk factors to the CHADS2 score: Age 65–74 years, Vascular Disease, and Sex Category (Female). Results: Overall, 324,172 patients with NVAF with mean CHADS2 and CHA2DS2-VASc scores of 1.51 and 3.08, respectively, were included in the study. Of these patients, 299,716 (92.5 {\%}) took chronic medications, with an average of 6.9 medications per patient, and 215,527 (66.5 {\%} of all patients or 71.9 {\%} of those taking chronic medications) took medications more than once per day. Conclusion: Use of chronic medications other than anticoagulants is common among patients with NVAF, and medications are typically taken multiple times per day. The average number of medications per patient and multiple therapeutic classes prescribed underscore the clinical complexity of NVAF patients. Hence, the choice of a once daily anticoagulant versus a more than once daily anticoagulant may be less relevant in a real world NVAF population in terms of a potential convenience benefit.",
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Kocis, PT, Liu, G, Makenbaeva, D, Trocio, J, Velott, D, Trainer, JAB, Abdulsattar, Y, Molina, MI & Leslie, D 2016, 'Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation', Drugs - Real World Outcomes, vol. 3, no. 2, pp. 165-173. https://doi.org/10.1007/s40801-016-0072-7

Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation. / Kocis, Paul T.; Liu, Guodong; Makenbaeva, Dinara; Trocio, Jeffrey; Velott, Diana; Trainer, Jo Ann B.; Abdulsattar, Younos; Molina, Marta I.; Leslie, Douglas.

In: Drugs - Real World Outcomes, Vol. 3, No. 2, 01.06.2016, p. 165-173.

Research output: Contribution to journalArticle

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T1 - Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation

AU - Kocis, Paul T.

AU - Liu, Guodong

AU - Makenbaeva, Dinara

AU - Trocio, Jeffrey

AU - Velott, Diana

AU - Trainer, Jo Ann B.

AU - Abdulsattar, Younos

AU - Molina, Marta I.

AU - Leslie, Douglas

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N2 - Background: Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice. Objective: The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily. Methods: Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day. Prescription medications, co-morbidities, and CHADS2 and CHA2DS2-VASc scores were evaluated. CHADS2 assesses the risk of stroke in NVAF patients with the following risk factors: Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and history of prior Stroke or transient ischemic attack. The CHA2DS2-VASc score adds the following risk factors to the CHADS2 score: Age 65–74 years, Vascular Disease, and Sex Category (Female). Results: Overall, 324,172 patients with NVAF with mean CHADS2 and CHA2DS2-VASc scores of 1.51 and 3.08, respectively, were included in the study. Of these patients, 299,716 (92.5 %) took chronic medications, with an average of 6.9 medications per patient, and 215,527 (66.5 % of all patients or 71.9 % of those taking chronic medications) took medications more than once per day. Conclusion: Use of chronic medications other than anticoagulants is common among patients with NVAF, and medications are typically taken multiple times per day. The average number of medications per patient and multiple therapeutic classes prescribed underscore the clinical complexity of NVAF patients. Hence, the choice of a once daily anticoagulant versus a more than once daily anticoagulant may be less relevant in a real world NVAF population in terms of a potential convenience benefit.

AB - Background: Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice. Objective: The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily. Methods: Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day. Prescription medications, co-morbidities, and CHADS2 and CHA2DS2-VASc scores were evaluated. CHADS2 assesses the risk of stroke in NVAF patients with the following risk factors: Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and history of prior Stroke or transient ischemic attack. The CHA2DS2-VASc score adds the following risk factors to the CHADS2 score: Age 65–74 years, Vascular Disease, and Sex Category (Female). Results: Overall, 324,172 patients with NVAF with mean CHADS2 and CHA2DS2-VASc scores of 1.51 and 3.08, respectively, were included in the study. Of these patients, 299,716 (92.5 %) took chronic medications, with an average of 6.9 medications per patient, and 215,527 (66.5 % of all patients or 71.9 % of those taking chronic medications) took medications more than once per day. Conclusion: Use of chronic medications other than anticoagulants is common among patients with NVAF, and medications are typically taken multiple times per day. The average number of medications per patient and multiple therapeutic classes prescribed underscore the clinical complexity of NVAF patients. Hence, the choice of a once daily anticoagulant versus a more than once daily anticoagulant may be less relevant in a real world NVAF population in terms of a potential convenience benefit.

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