title: Persistence on warfarin in patients with atrial fibrillation: experience in Australia 2006-2009.
abstract: BACKGROUND
  Long-term persistence on warfarin in patients with non-valvular atrial fibrillation is essential to minimise thromboembolic complications, especially ischaemic stroke. This study examines persistence in Australian patients with presumed atrial fibrillation newly prescribed warfarin.
  
  
  METHODS
  Longitudinal assessment of Pharmaceutical Benefit Scheme payment claim records from October 2006 through September 2009 in a 10% random sample of the Australian population holding long-term concession cards.
  
  
  METHODS
  proportion not filling first repeat prescription, median persistence time on medication, long-term persistence at 33 months.
  
  
  RESULTS
  A total of 1 108 patients (representative of 11 080 nationally) were newly prescribed warfarin; mean age 74 years, 50% were females. Fifteen percent (95% CI: 13-17) failed to collect the first repeat prescription, median persistence time on medication was only 12 months (95% CI: 10-13), long-term persistence at 33 months was 26% (95% CI: 23-27).
  
  
  CONCLUSIONS
  There is significant discontinuation of warfarin therapy. When due to non-compliance, an opportunity for stroke prevention is being lost.
authors.affiliation: MD, FRACP, is Associate Professor of Medicine and Director, Lipid Research Department, University of New South Wales, St Vincent's Hospital, New South Wales.
authors.forename: Leon A
authors.initials: LA
authors.lastname: Simons
authors.forename: Michael
authors.initials: M
authors.lastname: Ortiz
authors.forename: Peter
authors.initials: P
authors.lastname: Germanos
authors.forename: Gordon
authors.initials: G
authors.lastname: Calcino
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001315:Australia; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D014859:Warfarin / Q000627:therapeutic use*; D016903:Drug Monitoring
chemical_list: D000925:Anticoagulants; D014859:Warfarin