title: [Temporal trend analysis of poorly controlled anticoagulated patients in a cohort of primary care patients].
abstract: OBJECTIVE
  To determine the temporal trend in poorly-controlled anticoagulated patients.
  
  
  METHODS
  A longitudinal study was conducted on a non-unselected sample of all patients seen in a health centre over a period of 3 years (2011-2013). Patients who received anti-vitamin K anticoagulation for at least 6 months due to non-valvular atrial fibrillation were selected, obtaining a final sample of 130 patients.
  
  
  RESULTS
  The mean age of the sample was 77.0±1.5 years and 53.1% were male. The prevalence of hypertension and diabetes mellitus was 90% and 33.8%, respectively, and 11.5% and 14.6% had had heart failure or a stroke, respectively. The mean number of medications taken by patients was 7.6±0.6. The prevalence of insufficient control of time in therapeutic range, calculated by Rosendaal, was 60.2% in 2011, 54.2% in 2010, and 43.4% in 2012. On analysing the time in the therapeutic range in patients with impaired control in the first quarter of follow-up, it was observed to remain low in subsequent years: 69.7% vs 55%, P=.0005, in 2011; 71.9% vs 59.3%, P=.0015 in 2012; and 74.7% vs 60%, P=.0005 in 2013.
  
  
  CONCLUSIONS
  Our study shows that patients with inadequate time in therapeutic range have a tendency to stay in poor control, suggesting the need for early clinical decisions in patients on anticoagulants, taking into account the prognosis and economic costs of atrial fibrillation and treatment.
authors: Centro de Salud de Porto do Son, Xerencia de Xestión Integrada, Santiago de Compostela, España.
authors: E
authors: E
authors: Gestal-Pereira
authors: Centro de Salud de Porto do Son, Xerencia de Xestión Integrada, Santiago de Compostela, España. Electronic address: Sergio.cinza.sanjurjo@sergas.es.
authors: S
authors: S
authors: Cinza-Sanjurjo
authors: Centro de Salud de A Estrada, Xerencia de Xestión Integrada, Santiago de Compostela, España.
authors: D
authors: D
authors: Rey-Aldana
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D011320:Primary Health Care; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Anticoagulación; Anticoagulation; Fibrilación auricular no valvular; Non-valvular atrial fibrillation; Tiempo en rango terapéutico; Time in therapeutic range