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Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors’ adherence to warfarin therapy recommendations

A Swedish study of prescribed drugs in primary care in 2002 and 2007

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Background

Little is known about prescription trends in atrial fibrillation (AF) in primary health care in Sweden.

Objective

The aim was to study time trends in pharmacotherapy, in men and women with AF. We also aimed at studying doctors’ adherence to CHADS2 for prescribing warfarin. CHADS2 assesses stroke risk by presence of known risk factors, i.e., congestive heart failure, hypertension, age >75 years, diabetes, previous stroke and transient ischemic attack.

Methods

Data were obtained from primary health care records that contained individual clinical data. In total, 371,036 patients were included in the sample from 2002, and 424,329 patients were included in the sample from 2007. The study population consisted of individuals aged 45+ years who were diagnosed with AF in 2002 (1,330 men and 1,096 women) and 2007 (2,748 men and 2,234 women). The pharmacotherapies prescribed in 2002 and 2007 were analyzed separately in men and women. Logistic regression was used to calculate the association between the CHADS2 score and prescribed warfarin treatment.

Results

Selective beta-blockers, anti-coagulant therapy and lipid-lowering drugs were prescribed more frequently in 2007 than in 2002. In 2007, antithrombotic and RAS-blocking agents were prescribed more frequently to men, whereas beta-1 selective beta-blockers were prescribed more frequently to women. There was no consistent association between the CHADS2 score and prescribed warfarin treatment.

Conclusions

Pharmacotherapy of AF has improved over time, though CHADS2 guidelines need to be implemented systematically in primary health care in Sweden to decrease the risk of stroke and improve quality of life in patients with AF.

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Acknowledgments

This work was supported by grants to Kristina Sundquist and Jan Sundquist from the Swedish Research Council (K2005-27X-15428-01A, 2008-3110 and 2008-2638), the Swedish Council for Working Life and Social Research (2006-0386, 2007-1754 and 2007-1962) and the Swedish Research Council Formas (2006-4255-6596-99 and 2007-1352).

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Authors and Affiliations

  1. Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden

    Axel C. Carlsson & Per Wändell

  2. Department of Public Health and Caring Sciences/ Section of Geriatrics, Uppsala University, Uppsala, Sweden

    Axel C. Carlsson

  3. Center for Primary Health Care Research, Lund University, Region Skåne, Malmö, Sweden

    Kristina Sundquist, Sven-Erik Johansson & Jan Sundquist

  4. Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA

    Jan Sundquist

  5. Center for Family and Community Medicine, Karolinska Institutet, Alfred Nobels Allé 12, 141 83, Huddinge, Sweden

    Axel C. Carlsson

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  1. Axel C. Carlsson
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  2. Per Wändell
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  3. Kristina Sundquist
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  4. Sven-Erik Johansson
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  5. Jan Sundquist
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Correspondence to Axel C. Carlsson.

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Carlsson, A.C., Wändell, P., Sundquist, K. et al. Differences and time trends in drug treatment of atrial fibrillation in men and women and doctors’ adherence to warfarin therapy recommendations. Eur J Clin Pharmacol 69, 245–253 (2013). https://doi.org/10.1007/s00228-012-1322-6

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  • DOI: https://doi.org/10.1007/s00228-012-1322-6

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