Trends in utilization of management strategies for newly diagnosed atrial fibrillation patients in the united states 1999 to 2008
Journal of Pharmacy Practice, 05/11/2012
Kashyap A et al. – Medication therapy, especially rate–control strategies, remains the preferred initial therapy of choice.Methods
- 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.