title: Use of Chronic Medications Among Patients with Non-Valvular Atrial Fibrillation.
abstract: BACKGROUND
  Frequency of administration (once daily versus more than once daily) is believed to be an important consideration affecting drug choice.
  
  
  OBJECTIVE
  The aim of this study was to describe the characteristics of patients with non-valvular atrial fibrillation (NVAF) and the extent to which they take chronic medications, other than anticoagulants, more frequently than once daily.
  
  
  METHODS
  Using data from a large, national database of health insurance claims, patients with a diagnosis of NVAF between 1 July 2008 and 30 September 2011 were identified, along with their prescription medications, to determine the proportion of patients taking chronic medications more than once a day. Prescription medications, co-morbidities, and CHADS2and CHA2DS2-VASc scores were evaluated. CHADS2assesses the risk of stroke in NVAF patients with the following risk factors: Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, and history of prior Stroke or transient ischemic attack. The CHA2DS2-VASc score adds the following risk factors to the CHADS2score: Age 65-74 years, Vascular Disease, and Sex Category (Female).
  
  
  RESULTS
  Overall, 324,172 patients with NVAF with mean CHADS2and CHA2DS2-VASc scores of 1.51 and 3.08, respectively, were included in the study. Of these patients, 299,716 (92.5 %) took chronic medications, with an average of 6.9 medications per patient, and 215,527 (66.5 % of all patients or 71.9 % of those taking chronic medications) took medications more than once per day.
  
  
  CONCLUSIONS
  Use of chronic medications other than anticoagulants is common among patients with NVAF, and medications are typically taken multiple times per day. The average number of medications per patient and multiple therapeutic classes prescribed underscore the clinical complexity of NVAF patients. Hence, the choice of a once daily anticoagulant versus a more than once daily anticoagulant may be less relevant in a real world NVAF population in terms of a potential convenience benefit.
authors.affiliation: Anticoagulation Clinic, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Kocis
authors.affiliation: Public Health Sciences, Penn State University, College of Medicine, Hershey, PA USA.
authors.forename: Guodong
authors.initials: G
authors.lastname: Liu
authors.affiliation: Bristol-Myers Squibb, Plainsboro, NJ USA.
authors.forename: Dinara
authors.initials: D
authors.lastname: Makenbaeva
authors.affiliation: Pfizer, New York, NY USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Trocio
authors.affiliation: Public Health Sciences, Penn State University, College of Medicine, Hershey, PA USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Velott
authors.affiliation: Pfizer, New York, NY USA.
authors.forename: JoAnn B
authors.initials: JB
authors.lastname: Trainer
authors.affiliation: Pfizer, New York, NY USA.
authors.forename: Younos
authors.initials: Y
authors.lastname: Abdulsattar
authors.affiliation: Bristol-Myers Squibb, Plainsboro, NJ USA.
authors.forename: Marta I
authors.initials: MI
authors.lastname: Molina
authors.affiliation: Public Health Sciences, Penn State University, College of Medicine, Hershey, PA USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Leslie