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- Title
Reasons for Undertreatment with Oral Anticoagulants in Frail Geriatric Outpatients with Atrial Fibrillation.
- Authors
Tulner, Linda R.; Van Campen, Jos P. C. M.; Kuper, Ingeborg M. J. A.; Gijsen, George J. P. T.; Koks, Cornelis H. W.; Mac Gillavry, Melvin R.; van Tinteren, Harm; Beijnen, Jos H.; Brandjes, Desiderius P. M.
- Abstract
Objectives: The main aims of the study were to explore whether oral anticoagulation (OAC) for atrial fibrillation (AF) in geriatric outpatients is prescribed in accordance with international (American College of Cardiology/American Heart Association/European Society of Cardiology [ACC/AHA/ESC]) and Dutch national guidelines for the general practitioner (GP) and to identify whether age and selected co-morbid conditions are associated with undertreatment. As a secondary objective, we wanted to establish how many patients discontinue OAC because of major bleeding. Methods: In 2004, at the first visit of all patients to the geriatric day clinic of the Slotervaart Hospital in Amsterdam, the Netherlands, demographic data, Mini-Mental State Examination score, medical history, Charlson Comorbidity Index score, and data on medication use and changes were documented. The presence of AF was established by assessment ofmedical history information obtained by the GP, the history taken from patients and their caregivers, and the results of clinical evaluation, including ECG findings. Associations between the use of OAC, demographic data and co-morbid conditions registered in the Dutch NHG (Nederlands Huisartsen Genootschap [Dutch College of General Practitioners]) standard for GPs as risk factors for stroke or contraindications to the use of OAC were analysed. The reasons for discontinuing OAC were assessed after 4 years by requesting the information from the anticoagulation services or the GP.
- Subjects
ANTICOAGULANTS; ATRIAL fibrillation; COMORBIDITY; CAREGIVERS; MEDICAL history taking; HEMORRHAGE
- Publication
Drugs & Aging, 2010, Vol 27, Issue 1, p39
- ISSN
1170-229X
- Publication type
Article
- DOI
10.2165/11319540-000000000-00000