Non-vitamin K antagonist oral anticoagulant use at doses inappropriately lower than recommended in outpatient older adults: a real-life data

Abstract: Introduction: Despite a progress in the management of patients with atrial fibrillation this arrhythmia is one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Oral anticoagulation with vitamin K antagonist or non-vitamin K antagonist markedly reduces stroke and mortality in atrial fibrillation patients. Aim: To estimate the real-life vitamin K antagonist and non-vitamin K antagonist oral anticoagulant treatment in past years in Hungary. Method: Analysis of the National Health Insurance Administation database for atrial fibrillation (BNO: I48) between 2010–2015. We assumed that AF patient would turn to health care provides at least once either as inpatients or outpatients in a 5-year period. The patient was accepted as adherent after 6 months therapy and at least 80% oral anticoagulant prescription. Results: The prevalence of AF in Hungary is 3%. The mortality rate of AF 7%–10% per year. The adherence of the old oral anticoagulant treatment was 55%, but it was 69% among patient treated by “new” oral anticoagulant treatment. However, one third of the patients are not treated by effective old or new oral anticoagulant treatment. Conclusions: We need more effort to improve the effective and high adherence oral anticoagulant therapy in our country. Orv Hetil. 2017; 158(39): 1545–1549.

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Adherence to oral anticoagulant therapy in patients with atrial fibrillation

Thrombosis and Haemostasis ◽

10.1160/th16-10-0757 ◽

2017 ◽

Vol 117 (02) ◽

pp. 209-218 ◽

Cited By ~ 83

Author(s):

Valeria Raparelli ◽

Marco Proietti ◽

Roberto Cangemi ◽

Gregory Y. H. Lip ◽

Deirdre A. Lane ◽

...

Keyword(s):

Atrial Fibrillation ◽

Vitamin K ◽

Oral Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Real Life ◽

Vitamin K Antagonist ◽

Anticoagulation Management ◽

Thromboembolic Risk ◽

Real Life Data

SummaryOral anticoagulation is pivotal in the management of thromboembolic risk in non-valvular atrial fibrillation (NVAF) patients. Effective anticoagulation is important to avoid major adverse events and medication adherence is central to achieve good anticoagulation control. Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as vitamin K antagonist (VKAs) in NVAF patients. Due to the absence of routine anticoagulation monitoring with NOACs treatment, concerns have been raised about patient’s adherence to NOACs and real-life data demonstrates variability in adherence and persistence. A multi-level approach, including patients’ preferences, factors determining physicians’ prescribing habits and healthcare system infrastructure and support, is warranted to improve initiation and adherence of anticoagulants. Adherence to NOACs is paramount to achieve a clinical benefit. Implementation of educational programs and easy-to-use tools to identify patients most likely to be non-adherent to NOACs, are central issues in improving the quality of NVAF anticoagulation management.Note: The review process for this manuscript was fully handled by C. Weber, Editor in Chief.

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Abstract #601 Mortality; Major Adverse Cardiovascular Events (Mace) and Weight are Reduced in 400 Hypogonadal Men on Long-Term Testosterone Therapy (TTH) Compared to 376 Untreated Hypogonadal Controls: Real-Life Data from A 10-Year Registry

Endocrine Practice ◽

10.1016/s1530-891x(20)47240-4 ◽

2018 ◽

Vol 24 ◽

pp. 143

Author(s):

Farid Saad ◽

Ahmad Haider ◽

Karim Haider ◽

Gheorghe Doros ◽

Abdulmaged Traish

Keyword(s):

Cardiovascular Events ◽

Real Life ◽

Major Adverse Cardiovascular Events ◽

Testosterone Therapy ◽

Life Data ◽

Real Life Data

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Abstract #1216 Improvement of Blood Pressure (Bp); Heart Rate and Other Hemodynamic Markers in Hypogonadal Patients with Hypertension Receiving Long-Term Testosterone Therapy (Tth) Compared to Untreated Hypogonadal Controls: Real-Life Data from a 10-Year Registry

Endocrine Practice ◽

10.1016/s1530-891x(20)47508-1 ◽

2018 ◽

Vol 24 ◽

pp. 312-313

Author(s):

Farid Saad ◽

Ahmad Haider ◽

Karim Haider ◽

Gheorghe Doros ◽

Abdulmaged Traish

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Real Life ◽

Testosterone Therapy ◽

Life Data ◽

Real Life Data

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Neuropsychology in the Real World

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000139 ◽

2014 ◽

Vol 25 (4) ◽

pp. 233-238 ◽

Cited By ~ 2

Author(s):

Martin Peper ◽

Simone N. Loeffler

Keyword(s):

Neuropsychological Assessment ◽

Real World ◽

Ecological Validity ◽

Real Life ◽

Emotional States ◽

Context Sensitive ◽

Traditional Assessment ◽

Life Data ◽

Real Life Data ◽

Assessment And Treatment

Current ambulatory technologies are highly relevant for neuropsychological assessment and treatment as they provide a gateway to real life data. Ambulatory assessment of cognitive complaints, skills and emotional states in natural contexts provides information that has a greater ecological validity than traditional assessment approaches. This issue presents an overview of current technological and methodological innovations, opportunities, problems and limitations of these methods designed for the context-sensitive measurement of cognitive, emotional and behavioral function. The usefulness of selected ambulatory approaches is demonstrated and their relevance for an ecologically valid neuropsychology is highlighted.

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