National underuse of anti-thrombotic therapy in chronic atrial fibrillation identified from digoxin prescribing.
OBJECTIVE
To examine if appropriate antithrombotic therapy in atrial fibrillation is implemented nationally.


METHODS
Using prescriptions for digoxin as a surrogate for atrial fibrillation, we identified its coprescription with antithrombotic therapy, aspirin or warfarin in a national prescribing database in 27 571 patients over 45 years old.


RESULTS
Proportionately significantly more men were on warfarin, and use in those >75 years old was three times less than in those <65 years. Reluctance to use antithrombotics was confirmed in a postal survey.


CONCLUSIONS
Data suggest a missed opportunity to prevent stroke with women and those >75 years old least likely to receive warfarin.
Mahmud
Azra
A
Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland.
Bennett
Kathleen
K
Okechukwu
Ifeanyi
I
Feely
John
J
D000367:Age Factors; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000191:economics; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004077:Digoxin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013927:Thrombosis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D016861:Cyclooxygenase Inhibitors; D014859:Warfarin; D004077:Digoxin; D001241:Aspirin