Clinical characteristics of patients with atrial fibrillation treated with direct oral anticoagulants attended in primary care setting. The SILVER-AP study Perfil clínico de pacientes con fibrilación auricular tratados con anticoagulantes orales de acción directa atendidos en atención primaria. Estudio SILVER-AP
de la Figuera, Mariano (Institut d'Investigació Biomèdica Sant Pau)
Cinza, Sergio (Centro de Saúde (CS) Porto do Son)
Marín, Nuria (Bayer Hispania S.L.. General Medicine CV)
Egocheaga, Isabel (Centro de Salud Isla de Oza)
Prieto, Miguel Angel (Centro de Salud (CS) Vallobín-La Florida)
Universitat Autònoma de Barcelona

Data:	2018
Resum:	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 CHADS-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 20 mg/daily. Of the patients receiving dabigatran, 41. 7% were taking the dose of 150 mg twice daily, and in the case of apixaban, 56. 2% were taking the dose of 5 mg 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Castellà
Document:	Article ; recerca ; Versió publicada
Matèria:	Anticoagulación ; Anticoagulantes orales de acción directa ; Anticoagulation ; Atención primaria ; Direct oral anticoagulants ; Fibrilación auricular no valvular ; Non-valvular atrial fibrillation ; Primary care
Publicat a:	Atencion Primaria, Vol. 50 Núm. 6 (junio 2018) , p. 359-367, ISSN 1578-1275

DOI: 10.1016/j.aprim.2017.05.009
PMID: 28764897

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