Clinical characteristics of patients with atrial fibrillation treated with direct oral anticoagulants attended in primary care setting. The SILVER-AP study

• Published in: Atención primaria 2018-06, Vol.50 (6), p.359
• Main Authors: de la Figuera, Mariano, Cinza, Sergio, Marín, Nuria, Egocheaga, Isabel, Prieto, Miguel Angel
• Format: Article
• Language: Spanish
• Subjects: Administration, Oral; Aged; Antithrombins - administration & dosage; Antithrombins - therapeutic use; Atrial Fibrillation - complications; Cross-Sectional Studies; Dabigatran - administration & dosage; Dabigatran - therapeutic use; Female; Humans; Male; Medication Adherence - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Primary Health Care; Rivaroxaban - administration & dosage; Rivaroxaban - therapeutic use; Stroke - etiology; Stroke - prevention & control
• ISSN: 1578-1275; 1578-1275
• DOI: 10.1016/j.aprim.2017.05.009

To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC). Observational, cross-sectional and multicentre study. Autonomous Communities in which the general practitioner can prescribe DOAC (n=9). The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months. A record was made of the sociodemographic and clinical management date. Mean age was 78.6±8.4 years, and 50.5% of patients were men. Mean CHADS score was 2.6±1.2, mean CHA DS -VASc score was 4.3±1.6, and the mean HAS-BLED score was 2.3±1.0. Mean duration of treatment with DOAC was 15.8±12.5 months. Rivaroxaban was the DOAC most frequently prescribed (57.8%), followed by dabigatran (23.7%), and apixaban (18.5%). Of the patients receiving rivaroxaban, 70.2% were taking the dose of 20mg/daily. Of the patients receiving dabigatran, 41.7% were taking the dose of 150mg twice daily, and in the case of apixaban, 56.2% were taking the dose of 5mg twice daily. Satisfaction (ACTS Burdens scale 52.0±7.2 and ACTS Benefits scale 12.1±2.2), and therapeutic adherence (97.8% of patients took their medication regularly) with DOAC were high. Patients treated with DOAC in Spain have a high thromboembolic risk. A significant proportion of patients receive a lower dose of DOAC than that recommended according to their clinical profile. Satisfaction and medication adherence are high.