title: Trends in utilization of management strategies for newly diagnosed atrial fibrillation patients in the United States: 1999 to 2008.
abstract: OBJECTIVE
  To describe the trend in atrial fibrillation (AF) treatment strategies in newly diagnosed AF patients between 1999 and 2008.
  
  
  METHODS
  The study was a retrospective cohort study of commercial health plans claims data. Newly diagnosed adult AF patients with ≥1 claim for an AF-related intervention within 12 months of diagnosis were identified. Based on initial treatment, patients were classified into pharmacotherapy or nonpharmacotherapy groups. Pharmacotherapy group was subcategorized into rate-control or rhythm-control groups. Linear regression to assess linear trend and multinomial logistic regression to evaluate factors associated with treatment choice were conducted.
  
  
  RESULTS
  Three thousand ninety-four newly diagnosed AF patients were identified. Eighty percent of these patients were initiated on pharmacotherapy with the majority (84%) receiving rate-control medications only. Relative distribution of the 3 treatment groups remained similar over the study period. However, within the rate-control group, the use of beta blockers increased significantly (P < .001). Treatment with nonpharmacotherapy over rate-control medications was higher in males but lower in patients aged ≥80 (relative risk ratio [RRR]: 1.67, 95% confidence interval [CI]: 1.27-2.20 and RRR: 0.48, 95% CI: 0.30-0.77, respectively). Having stroke and congestive heart failure significantly affected the treatment choice between nonpharmacotherapy and rate-control medications.
  
  
  CONCLUSIONS
  Medication therapy, especially rate-control strategies, remains the preferred initial therapy of choice.
authors.affiliation: Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Arpit
authors.initials: A
authors.lastname: Kashyap
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents
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