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Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018

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Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018. / Phillips, Katherine; Subramanian, Anuradhaa; Thomas, G Neil; Khan, Nazish; Chandan, Joht Singh; Brady, Paul; Marshall, Tom; Nirantharakumar, Krishnarajah; Fabritz, Larissa; Adderley, Nicola Jaime.

In: HEART, Vol. 108, No. 7, 04.2022, p. 517-522.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Phillips, K, Subramanian, A, Thomas, GN, Khan, N, Chandan, JS, Brady, P, Marshall, T, Nirantharakumar, K, Fabritz, L & Adderley, NJ 2022, 'Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018', HEART, vol. 108, no. 7, pp. 517-522. https://doi.org/10.1136/heartjnl-2021-319338

APA

Phillips, K., Subramanian, A., Thomas, G. N., Khan, N., Chandan, J. S., Brady, P., Marshall, T., Nirantharakumar, K., Fabritz, L., & Adderley, N. J. (2022). Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018. HEART, 108(7), 517-522. https://doi.org/10.1136/heartjnl-2021-319338

Vancouver

Phillips K, Subramanian A, Thomas GN, Khan N, Chandan JS, Brady P et al. Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018. HEART. 2022 Apr;108(7):517-522. https://doi.org/10.1136/heartjnl-2021-319338

Bibtex

@article{dc1464984d3146558e88573e0d3a396c,
title = "Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018",
abstract = "OBJECTIVE: The pharmacological management of atrial fibrillation (AF) comprises anticoagulation, for stroke prophylaxis, and rate or rhythm control drugs to alleviate symptoms and prevent heart failure. The aim of this study was to investigate trends in the proportion of patients with AF prescribed pharmacological therapies in the UK between 2008 and 2018.METHODS: Eleven sequential cross-sectional analyses were performed yearly from 2008 to 2018. Data were derived from an anonymised UK primary care database. Outcomes were the proportion of patients with AF prescribed anticoagulants, rhythm and rate control drugs in the whole cohort, those at high risk of stroke and those with coexisting heart failure.RESULTS: Between 2008 and 2018, the proportion of patients prescribed anticoagulants increased from 45.3% (95% CI 45.0% to 45.7%) to 71.1% (95% CI 70.7% to 71.5%) driven by increased prescription of non-vitamin K antagonist anticoagulants. The proportion of patients prescribed rate control drugs remained constant between 2008 and 2018 (69.3% (95% CI 68.9% to 69.6%) to 71.6% (95% CI 71.2% to 71.9%)). The proportion of patients prescribed rhythm control therapy by general practitioners (GPs) decreased from 9.5% (95% CI 9.3% to 9.7%) to 5.4% (95% CI 5.2% to 5.6%).CONCLUSIONS: There has been an increase in the proportion of patients with AF appropriately prescribed anticoagulants following National Institute for Health and Care Excellence and European Society of Cardiology guidelines, which correlates with improvements in mortality and stroke outcomes. Beta-blockers appear increasingly favoured over digoxin for rate control. There has been a steady decline in GP prescribing rates for rhythm control drugs, possibly related to concerns over efficacy and safety and increased availability of AF ablation.",
author = "Katherine Phillips and Anuradhaa Subramanian and Thomas, {G Neil} and Nazish Khan and Chandan, {Joht Singh} and Paul Brady and Tom Marshall and Krishnarajah Nirantharakumar and Larissa Fabritz and Adderley, {Nicola Jaime}",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2022",
month = apr,
doi = "10.1136/heartjnl-2021-319338",
language = "English",
volume = "108",
pages = "517--522",
journal = "HEART",
issn = "1355-6037",
publisher = "BMJ PUBLISHING GROUP",
number = "7",

}

RIS

TY - JOUR

T1 - Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018

AU - Phillips, Katherine

AU - Subramanian, Anuradhaa

AU - Thomas, G Neil

AU - Khan, Nazish

AU - Chandan, Joht Singh

AU - Brady, Paul

AU - Marshall, Tom

AU - Nirantharakumar, Krishnarajah

AU - Fabritz, Larissa

AU - Adderley, Nicola Jaime

N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/4

Y1 - 2022/4

N2 - OBJECTIVE: The pharmacological management of atrial fibrillation (AF) comprises anticoagulation, for stroke prophylaxis, and rate or rhythm control drugs to alleviate symptoms and prevent heart failure. The aim of this study was to investigate trends in the proportion of patients with AF prescribed pharmacological therapies in the UK between 2008 and 2018.METHODS: Eleven sequential cross-sectional analyses were performed yearly from 2008 to 2018. Data were derived from an anonymised UK primary care database. Outcomes were the proportion of patients with AF prescribed anticoagulants, rhythm and rate control drugs in the whole cohort, those at high risk of stroke and those with coexisting heart failure.RESULTS: Between 2008 and 2018, the proportion of patients prescribed anticoagulants increased from 45.3% (95% CI 45.0% to 45.7%) to 71.1% (95% CI 70.7% to 71.5%) driven by increased prescription of non-vitamin K antagonist anticoagulants. The proportion of patients prescribed rate control drugs remained constant between 2008 and 2018 (69.3% (95% CI 68.9% to 69.6%) to 71.6% (95% CI 71.2% to 71.9%)). The proportion of patients prescribed rhythm control therapy by general practitioners (GPs) decreased from 9.5% (95% CI 9.3% to 9.7%) to 5.4% (95% CI 5.2% to 5.6%).CONCLUSIONS: There has been an increase in the proportion of patients with AF appropriately prescribed anticoagulants following National Institute for Health and Care Excellence and European Society of Cardiology guidelines, which correlates with improvements in mortality and stroke outcomes. Beta-blockers appear increasingly favoured over digoxin for rate control. There has been a steady decline in GP prescribing rates for rhythm control drugs, possibly related to concerns over efficacy and safety and increased availability of AF ablation.

AB - OBJECTIVE: The pharmacological management of atrial fibrillation (AF) comprises anticoagulation, for stroke prophylaxis, and rate or rhythm control drugs to alleviate symptoms and prevent heart failure. The aim of this study was to investigate trends in the proportion of patients with AF prescribed pharmacological therapies in the UK between 2008 and 2018.METHODS: Eleven sequential cross-sectional analyses were performed yearly from 2008 to 2018. Data were derived from an anonymised UK primary care database. Outcomes were the proportion of patients with AF prescribed anticoagulants, rhythm and rate control drugs in the whole cohort, those at high risk of stroke and those with coexisting heart failure.RESULTS: Between 2008 and 2018, the proportion of patients prescribed anticoagulants increased from 45.3% (95% CI 45.0% to 45.7%) to 71.1% (95% CI 70.7% to 71.5%) driven by increased prescription of non-vitamin K antagonist anticoagulants. The proportion of patients prescribed rate control drugs remained constant between 2008 and 2018 (69.3% (95% CI 68.9% to 69.6%) to 71.6% (95% CI 71.2% to 71.9%)). The proportion of patients prescribed rhythm control therapy by general practitioners (GPs) decreased from 9.5% (95% CI 9.3% to 9.7%) to 5.4% (95% CI 5.2% to 5.6%).CONCLUSIONS: There has been an increase in the proportion of patients with AF appropriately prescribed anticoagulants following National Institute for Health and Care Excellence and European Society of Cardiology guidelines, which correlates with improvements in mortality and stroke outcomes. Beta-blockers appear increasingly favoured over digoxin for rate control. There has been a steady decline in GP prescribing rates for rhythm control drugs, possibly related to concerns over efficacy and safety and increased availability of AF ablation.

U2 - 10.1136/heartjnl-2021-319338

DO - 10.1136/heartjnl-2021-319338

M3 - SCORING: Journal article

C2 - 34226195

VL - 108

SP - 517

EP - 522

JO - HEART

JF - HEART

SN - 1355-6037

IS - 7

ER -