title: Prescribing trends of atrial fibrillation patients who switched from warfarin to a direct oral anticoagulant.
abstract: Direct oral anticoagulant (DOAC) agents offer several lifestyle and therapeutic advantages for patients relative to warfarin in the treatment of atrial fibrillation (AF). These alternative agents are increasingly used in the treatment of AF, however the adoption practices, patient profiles, and reasons for switching to a DOAC from warfarin have not been well studied. Through the Michigan Anticoagulation Quality Improvement Initiative, abstracted data from 3873 AF patients, enrolled between 2010 and 2015, were collected on demographics and comorbid conditions, stroke and bleeding risk scores, and reasons for anticoagulant switching. Over the study period, patients who switched from warfarin to a DOAC had similar baseline characteristics, risk scores, and insurance status but differed in baseline CrCl. The most common reasons for switching were patient related ease of use concerns (37.5%) as opposed to clinical reasons (16.5% of patients). Only 13% of patients that switched to a DOAC switched back to warfarin by the end of the study period.
authors.affiliation: Texas Heart Institute, CHI-Baylor St. Luke's Medical Center, 6720 Bertner Ave. MC-1-133, Houston, TX, 77030, USA. Zachary.Hale@bcm.edu.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Hale
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: Xiowen
authors.initials: X
authors.lastname: Kong
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Haymart
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: Xiaokui
authors.initials: X
authors.lastname: Gu
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Kline-Rogers
authors.affiliation: William Beaumont Hospital, 4600 Investment Drive Suite 200, Troy, MI, 48098, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Almany
authors.affiliation: Huron Valley Sinai Hospital, 1 William Carls Drive, Commerce, MI, 48382, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Kozlowski
authors.affiliation: Henry Ford Hospital, 2799 W. Grand Blvd., Detroit, MI, 48202, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Krol
authors.affiliation: Henry Ford Hospital, 2799 W. Grand Blvd., Detroit, MI, 48202, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Kaatz
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: James B
authors.initials: JB
authors.lastname: Froehlich
authors.affiliation: University of Michigan Cardiovascular Center, 24 Frank Lloyd Wright Dr., Lobby A Rm 3201, Ann Arbor, MI, 48106, USA.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Barnes
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D057915:Drug Substitution / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Apixaban; Atrial fibrillation; DOAC; Dabigatran; NOAC; Rivaroxaban