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意大利真实世界中房颤的抗栓预防:一项回顾性研究。

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

作者信息

Ermini Giuliano, Perrone Valentina, Veronesi Chiara, Degli Esposti Luca, Di Pasquale Giuseppe

机构信息

General Practice, Bologna, Italy.

CliCon S.r.l. Health, Economics and Outcomes Research, Ravenna, Italy.

出版信息

Vasc Health Risk Manag. 2017 Jul 5;13:239-246. doi: 10.2147/VHRM.S136009. eCollection 2017.

Abstract

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.

摘要

目的

本研究旨在评估已确诊房颤(AF)的患病率、房颤患者使用抗血栓(AT)策略方面的药物使用情况及治疗依从性,并描述房颤患者在治疗方面的特征。

方法

所收集的数据来自意大利博洛尼亚地方卫生单位全科医生(GP)的数据库。对2009年1月1日至2012年12月31日期间,参与研究的44名全科医生所随访的所有年龄≥18岁的受试者进行评估,将诊断为房颤的受试者纳入分析。

结果

2009年至2012年期间,我们确定了1413例诊断为房颤的患者(占44名全科医生的67517例患者中的2.09%)。共有1413例诊断为房颤的患者(占44名全科医生的67517例患者中的2.09%)纳入本研究。在研究期间,14%的纳入患者未接受任何抗血栓药物处方,30%和39.56%的患者分别仅接受抗血小板(AP)药物和口服抗凝剂(OAC)治疗,16.28%的患者同时接受了OAC和AP药物的处方;在同时接受两种药物处方的患者中,只有4.17%的患者同时接受了这两种治疗。在OAC使用者中,在观察的最后3个月仍使用索引药物治疗的患者比例为76.9%。

结论

我们的研究结果强调,从公共卫生角度来看,在意大利的实际环境中,普通人群中房颤的负担凸显了改善已知房颤患者适当使用抗血栓药物情况的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8396/5505677/e6a1d8d51842/vhrm-13-239Fig1.jpg

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