Leon A Simons1, Michael Ortiz, Peter Germanos, Gordon Calcino. 1. MD, FRACP, is Associate Professor of Medicine and Director, Lipid Research Department, University of New South Wales, St Vincent's Hospital, New South Wales.
Abstract
BACKGROUND: Long-term persistence on warfarin in patients with non-valvular atrial fibrillation is essential to minimise thromboembolic complications, especially ischaemic stroke. This study examines persistence in Australian patients with presumed atrial fibrillation newly prescribed warfarin. METHODS: Longitudinal assessment of Pharmaceutical Benefit Scheme payment claim records from October 2006 through September 2009 in a 10% random sample of the Australian population holding long-term concession cards. MAIN OUTCOME MEASURES: proportion not filling first repeat prescription, median persistence time on medication, long-term persistence at 33 months. RESULTS: A total of 1 108 patients (representative of 11 080 nationally) were newly prescribed warfarin; mean age 74 years, 50% were females. Fifteen percent (95% CI: 13-17) failed to collect the first repeat prescription, median persistence time on medication was only 12 months (95% CI: 10-13), long-term persistence at 33 months was 26% (95% CI: 23-27). DISCUSSION: There is significant discontinuation of warfarin therapy. When due to non-compliance, an opportunity for stroke prevention is being lost.
BACKGROUND: Long-term persistence on warfarin in patients with non-valvular atrial fibrillation is essential to minimise thromboembolic complications, especially ischaemic stroke. This study examines persistence in Australian patients with presumed atrial fibrillation newly prescribed warfarin. METHODS: Longitudinal assessment of Pharmaceutical Benefit Scheme payment claim records from October 2006 through September 2009 in a 10% random sample of the Australian population holding long-term concession cards. MAIN OUTCOME MEASURES: proportion not filling first repeat prescription, median persistence time on medication, long-term persistence at 33 months. RESULTS: A total of 1 108 patients (representative of 11 080 nationally) were newly prescribed warfarin; mean age 74 years, 50% were females. Fifteen percent (95% CI: 13-17) failed to collect the first repeat prescription, median persistence time on medication was only 12 months (95% CI: 10-13), long-term persistence at 33 months was 26% (95% CI: 23-27). DISCUSSION: There is significant discontinuation of warfarin therapy. When due to non-compliance, an opportunity for stroke prevention is being lost.
Authors: Talitha I Verhoef; W Ken Redekop; Marcel L Bouvy; Brenda Dorenbos; Zamiera Karwar; Rianne M F van Schie; Anthonius de Boer; Anke-Hilse Maitland-van der Zee Journal: Br J Clin Pharmacol Date: 2014-08 Impact factor: 4.335
Authors: G Sanfélix-Gimeno; C L Rodríguez-Bernal; I Hurtado; C Baixáuli-Pérez; J Librero; S Peiró Journal: BMJ Open Date: 2015-10-19 Impact factor: 2.692
Authors: Juliana de Oliveira Costa; Claudia Bruno; Andrea L Schaffer; Smriti Raichand; Emily A Karanges; Sallie-Anne Pearson Journal: Int J Popul Data Sci Date: 2021-04-15