title: [Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care].
abstract: BACKGROUND
  In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases.
  
  
  METHODS
  This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months.
  
  
  RESULTS
  A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC.
  
  
  CONCLUSIONS
  The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient.
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España. Electronic address: dezfernan@ono.com.
authors.forename: P
authors.initials: P
authors.lastname: Fernández López
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España.
authors.forename: M I
authors.initials: MI
authors.lastname: López Ramiro
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España.
authors.forename: I
authors.initials: I
authors.lastname: Merino de Haro
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España.
authors.forename: G
authors.initials: G
authors.lastname: Cedeño Manzano
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Díaz Siles
authors.affiliation: Zona Básica de Salud de La Zubia, La Zubia, Granada, España.
authors.forename: A
authors.initials: A
authors.lastname: Hermoso Sabio
mesh_terms: D000074:Acenocoumarol / Q000627:therapeutic use*; D000284:Administration, Oral; D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D000074:Acenocoumarol
keywords: Antagonista de la vitamina K; Anticoagulación oral; Atención primaria; Atrial fibrillation; Fibrilación auricular; International normalised ratio; Oral anticoagulation therapy; Primary care; Razón normalizada internacional; Vitamin K antagonist