Trends in the outpatient treatment of atrial fibrillation in the USA from 2001 to 2010

ABSTRACT Purpose Several clinical trials have shown that rhythm‐control drugs have serious adverse events and no survival advantage over rate‐control drugs in patients with atrial fibrillation. The objectives were to determine and explain the recent trends in outpatient prescribing of both drug clas...

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Bibliographic Details
Published in:Pharmacoepidemiology and drug safety 2014-05, Vol.23 (5), p.539-547
Main Authors: Desai, Amarsinh M., Cavanaugh, Teresa M., Desai, Vibha C. A., Heaton, Pamela C., Kelton, Christina M. L.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Ambulatory Care - trends
Anti-Arrhythmia Agents - adverse effects
Anti-Arrhythmia Agents - pharmacology
Anti-Arrhythmia Agents - therapeutic use
Antiarythmic agents
atrial fibrillation
Atrial Fibrillation - drug therapy
beta-blockers
Biological and medical sciences
calcium channel blockers
Cardiac dysrhythmias
Cardiology. Vascular system
Cardiovascular system
Health Care Surveys
Heart
Humans
Logistic Models
Male
Medical sciences
Middle Aged
outpatient treatment
Outpatients
pharmacoepidemiology
Pharmacology. Drug treatments
Practice Patterns, Physicians' - trends
rate-control drugs
rhythm-control medications
United States
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Summary:ABSTRACT Purpose Several clinical trials have shown that rhythm‐control drugs have serious adverse events and no survival advantage over rate‐control drugs in patients with atrial fibrillation. The objectives were to determine and explain the recent trends in outpatient prescribing of both drug classes. Methods Data were obtained over 10 years from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Visits by patients with atrial fibrillation were identified by ICD‐9 diagnosis code 427.31. Trend lines were estimated for drug prescribing and comorbidities. A multinomial logistic model was estimated to predict treatment on the basis of visit characteristics. Results The percentage of visits mentioning only a rate‐control medication trended upward (p = 0.07) from 41.9% in 2001 to 47.3% in 2010; the percentage mentioning both rhythm‐control and rate‐control drugs also had an upward trend (p 
ISSN:1053-8569
1099-1557
DOI:10.1002/pds.3605