Trends in utilization of management strategies for newly diagnosed atrial fibrillation patients in the united states 1999 to 2008
Journal of Pharmacy Practice, 05/11/2012Kashyap A et al.
Medication therapy, especially rate–control strategies, remains the preferred initial therapy of choice.
The study was a retrospective cohort study of commercial health plans claims data.
Newly diagnosed adult AF patients with ≥1 claim for an AF–related intervention within 12 months of diagnosis were identified.
Based on initial treatment, patients were classified into pharmacotherapy or nonpharmacotherapy groups.
Pharmacotherapy group was subcategorized into rate–control or rhythm–control groups.
Linear regression to assess linear trend and multinomial logistic regression to evaluate factors associated with treatment choice were conducted.
Three thousand ninety–four newly diagnosed AF patients were identified.
Eighty percent of these patients were initiated on pharmacotherapy with the majority (84%) receiving rate–control medications only.
Relative distribution of the 3 treatment groups remained similar over the study period.
However, within the rate–control group, the use of beta blockers increased significantly (P < .001).
Treatment with nonpharmacotherapy over rate–control medications was higher in males but lower in patients aged ≥80 (relative risk ratio [RRR]: 1.67, 95% confidence interval [CI]: 1.27–2.20 and RRR: 0.48, 95% CI: 0.30–0.77, respectively).
Having stroke and congestive heart failure significantly affected the treatment choice between nonpharmacotherapy and rate–control medications.
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