Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross-sectional baseline analysis in general practice

摘要

What is known and objective: Antithrombotics for stroke prevention in atrial fibrillation (AF) are reportedly underutilised. Since the burden of care lies within general practice, attention must be paid to identifying and addressing practice gaps in this setting. The objective of this study was to determine the contemporary utilisation of antithrombotic therapy for stroke prevention in AF within Australian general practice (GP). Methods: Data pertaining to AF patients' (aged 65years) were collected from GP surgeries in New South Wales, Australia, using purpose-designed data collection forms; extracted data comprised patients' medical histories, current pharmacotherapy, and relevant characteristics. Results and Discussion: Data pertaining to 393 patients (mean age 780 +/- 70years) were reviewed. Overall, most (985%) patients received antithrombotic therapy. Among the 387 patients using antithrombotics, most (941%) received mono-therapy. Warfarin +/- antiplatelet was most frequently used (817%); 775% used warfarin as a monotherapy, followed by dabigatran +/- clopidogrel (116%), aspirin (59%) and clopidogrel alone (08%). High stroke risk and low bleeding risk were associated with increased use of warfarin +/- antiplatelet therapy. Older patients (80years) were more likely to receive nil therapy' (P=004), and less likely to receive dual and triple antithrombotic therapy. Conclusion: We found an encouraging improvement compared to previous studies in the utilisation of antithrombotic therapy for stroke prevention in AF within general practice. Warfarin is now utilised as the mainstay therapy, followed by aspirin, although the novel oral anticoagulants are entering the spectrum of therapies used. Consideration needs to be given to the potential impact of the newer agents and their scope of use.