Estarão os Doentes com Fibrilhação Auricular Correctamente Anticoagulados? Um Retrato de um Hospital Português do Interior
DOI:
https://doi.org/10.24950/rspmi.o.98.4.2021Keywords:
Aged; Anticoagulants; Atrial Fibrillation/drug therapy; Drug PrescriptionsAbstract
Introduction: Oral anticoagulants (OACs) have proven to minimize the risk of stroke in patients with atrial fibrillation (AF). However, the proportion of patients that are not on OACs and have indication to be is still high. Our aim was to evaluate the proportion of AF patients receiving anticoagulation therapy and to evaluate the quality of OACs prescribing.
Material and Methods: A cross-sectional study was undertaken in the Internal Medicine Department of a hospital from Alentejo (01-04/2019). Patients were included if they were aged ≥18, had previous history of non-valvular AF and presented a CHA₂DS₂-VASc ≥ 2 (male) or ≥ 3 (female). Both the number of patients that were using OACs and the number of patients that were correctly anticoagulated were extracted. Data analysis was performed using uni- and bivariate statistics (IBM SPSS v.20.0).
Results: A total of 203 patients were included, where 51.7% (n = 105) were female with a mean age of 80.2 ± 9.4 years old. Around 40% (n = 82) of those patients were not on OAC. Fifty-seven percent (n = 20) of patients that had previous history of cerebrovascular events were not on OACs. A quarter of the sample (n = 31) were incorrectly anticoagulated. Patients on OACs tended to be younger and with a higher number of concurrent medication (p = 0.001 and p = 0.027, respectively).
Conclusion: Data suggest a high proportion of patients eligible for OACs are not receiving treatment. Moreover, among those treated, a quarter was incorrectly anticoagulated. The institution of compulsory continuous professional development or health-system performance indicators should be considered to improve the prescribing pattern.
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