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Antithrombotic prophylaxis of atrial fibrillation in an Italian real-world setting: a retrospective study

Authors Ermini G, Perrone V, Veronesi C, Degli Esposti L, Di Pasquale G

Received 2 March 2017

Accepted for publication 3 May 2017

Published 5 July 2017 Volume 2017:13 Pages 239—246

DOI https://doi.org/10.2147/VHRM.S136009

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Takashi Kajiya

Giuliano Ermini,1 Valentina Perrone,2 Chiara Veronesi,2 Luca Degli Esposti,2 Giuseppe Di Pasquale3

On behalf of the GP Group

1General Practice, Bologna, Italy; 2CliCon S.r.l. Health, Economics and Outcomes Research, Ravenna, Italy; 3Department of Cardiology, Maggiore Hospital, Bologna, Italy

Objectives: The aims of this study were to assess the prevalence of diagnosed atrial fibrillation (AF), the drug use in patients with AF in terms of antithrombotic (AT) strategies used and the compliance with treatment, and to describe the characteristics of patients affected by AF in relation to treatment.
Methods: The data collected were provided from databases of general practitioners (GPs) of the Local Health Unit of Bologna in Italy. From January 1, 2009, to December 31, 2012, all subjects aged ≥18 years followed by the 44 GPs enrolled in the study were evaluated, and the subjects with a diagnosis of AF were included in the analysis.
Results: From 2009 to 2012, we identified 1,413 patients with a diagnosis of AF (2.09% of 67,517 patients of the 44 GPs). A total of 1,413 patients with a diagnosis of AF (2.09% of 67,517 patients of the 44 GPs) were enrolled in the study. During the study, 14% of the enrolled patients did not receive any prescription of ATs, 30% and 39.56% were treated only with antiplatelet (AP) agents and oral anticoagulants (OACs), respectively, and 16.28% of the patients received prescriptions for both an OAC and an AP agent; of the patients receiving prescriptions for both, only 4.17% received these therapies at the same time. Among the OAC users, the percentage of patients still on treatment with the index drug during the last 3 months of observation was 76.9%.
Conclusion: Our findings emphasize that in an Italian real-world setting, the burden of AF in general population from a public health point of view underscores the need for improvement in utilization of appropriate ATs in patients with known AF.

Keywords: atrial fibrillation, oral anticoagulant, antiplatelet agents, general practitioner, real world

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