Predictors of new oral anticoagulant drug initiation as opposed to warfarin in elderly adults: A retrospective observational study in Southern Italy

TY - JOUR

T1 - Predictors of new oral anticoagulant drug initiation as opposed to warfarin in elderly adults

T2 - A retrospective observational study in Southern Italy

AU - Guerriero, Francesca

AU - Orlando, Valentina

AU - Monetti, Valeria Marina

AU - Colaccio, Francesca Maria

AU - Sessa, Maurizio

AU - Scavone, Cristina

AU - Capuano, Annalisa

AU - Menditto, Enrica

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aim: The aim of this study was to assess the predictive role of age, gender, and number and type of co-treatments for new oral anticoagulant (NOAC) vs warfarin prescription in elderly patients naïve for the aforementioned drugs. Materials and methods: Data collected in the period from January 1, 2014, to December 31, 2014, in Caserta Local Health Unit administrative databases (Campania Region, Italy) were screened to identify new users of oral anticoagulants (OACs) who were 75 years or older and whose OAC prescriptions amounted to >90 days of treatment. Age, gender, and number and type of concomitant medications at the time of first OAC dispensation were retrieved. Multivariable logistic regression analysis was used to assess the role of the aforementioned predictors for NOAC initiation as opposed to warfarin. Results: Overall, 2,132 incident users of OAC were identified, of whom 967 met all inclusion criteria. In all, 490 subjects (50.7%) received an NOAC and 477 (49.3%) received warfarin. Age >75 years was positively associated with lower odds of NOAC initiation (OR: 0.969, 95% CI: 0.941–0.998, P=0.038). Similarly, multiple concomitant medication was negatively associated with NOAC initiation compared to warfarin (OR [five to nine drugs] group: 0.607, 95% CI: 0.432–0.852, P=0.004; OR [ten+ drugs] group: 0.372, 95% CI: 0.244–0.567, P<0.001). Prior exposure to platelet aggregation inhibitor drugs was associated with the initiation of NOACs (OR: 3.474, 95% CI: 2.610–4.625). Conclusion: Age and multiple co-medication were negatively associated with NOAC initiation.

AB - Aim: The aim of this study was to assess the predictive role of age, gender, and number and type of co-treatments for new oral anticoagulant (NOAC) vs warfarin prescription in elderly patients naïve for the aforementioned drugs. Materials and methods: Data collected in the period from January 1, 2014, to December 31, 2014, in Caserta Local Health Unit administrative databases (Campania Region, Italy) were screened to identify new users of oral anticoagulants (OACs) who were 75 years or older and whose OAC prescriptions amounted to >90 days of treatment. Age, gender, and number and type of concomitant medications at the time of first OAC dispensation were retrieved. Multivariable logistic regression analysis was used to assess the role of the aforementioned predictors for NOAC initiation as opposed to warfarin. Results: Overall, 2,132 incident users of OAC were identified, of whom 967 met all inclusion criteria. In all, 490 subjects (50.7%) received an NOAC and 477 (49.3%) received warfarin. Age >75 years was positively associated with lower odds of NOAC initiation (OR: 0.969, 95% CI: 0.941–0.998, P=0.038). Similarly, multiple concomitant medication was negatively associated with NOAC initiation compared to warfarin (OR [five to nine drugs] group: 0.607, 95% CI: 0.432–0.852, P=0.004; OR [ten+ drugs] group: 0.372, 95% CI: 0.244–0.567, P<0.001). Prior exposure to platelet aggregation inhibitor drugs was associated with the initiation of NOACs (OR: 3.474, 95% CI: 2.610–4.625). Conclusion: Age and multiple co-medication were negatively associated with NOAC initiation.

KW - Atrial fibrillation

KW - Drug utilization

KW - Oral anticoagulation

KW - Real-world data

KW - Retrospective databases

U2 - 10.2147/TCRM.S171346

DO - 10.2147/TCRM.S171346

M3 - Journal article

C2 - 30349269

AN - SCOPUS:85055342303

SN - 1176-6336

VL - 14

SP - 1907

EP - 1914

JO - Therapeutics and Clinical Risk Management

JF - Therapeutics and Clinical Risk Management

ER -