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Determinants of label non-adherence to non-vitamin K oral anticoagulants in patients with newly diagnosed atrial fibrillation.
Seelig, J; Trinks-Roerdink, E M; Chu, G; Pisters, R; Theunissen, L J H J; Trines, S A; Pos, L; Kirchhof, C J H J; de Jong, S F A M S; den Hartog, F R; van Alem, A P; Polak, P E; Tieleman, R G; van der Voort, P H; Lenderink, T; Otten, A M; de Jong, J S S G; Gu, Y L; Luermans, J G L M; Kruip, M J H A; Timmer, S A J; de Vries, T A C; Cate, H Ten; Geersing, G J; Rutten, F H; Huisman, M V; Hemels, M E W.
Afiliación
  • Seelig J; Department of Cardiology, Hospital Rijnstate, Rijnstate,  Arnhem, the Netherlands.
  • Trinks-Roerdink EM; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
  • Chu G; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands.
  • Pisters R; Department of General Practice, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
  • Theunissen LJHJ; Department of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, the Netherlands.
  • Trines SA; Department of Cardiology, Hospital Rijnstate, Rijnstate,  Arnhem, the Netherlands.
  • Pos L; Department of Cardiology, Maxima Medical Centre, Eindhoven, the Netherlands.
  • Kirchhof CJHJ; Willem Einthoven Centre for Cardiac Arrhythmia Research and Management, Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands.
  • de Jong SFAMS; Department of Cardiology, Hospital Group Twente, Hengelo, the Netherlands.
  • den Hartog FR; Department of Cardiology, Alrijne Hospital Leiderdorp, Leiderdorp, the Netherlands.
  • van Alem AP; Department of Cardiology, Elkerliek Hospital, Helmond, the Netherlands.
  • Polak PE; Department of Cardiology, Hospital Gelderse Vallei, Ede, the Netherlands.
  • Tieleman RG; Department of Cardiology, Haaglanden Medical Centre, The Hague, the Netherlands.
  • van der Voort PH; Department of Cardiology, St. Anna Hospital, Geldrop, the Netherlands.
  • Lenderink T; Department of Cardiology, Martini Hospital, Groningen, the Netherlands.
  • Otten AM; Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands.
  • de Jong JSSG; Department of Cardiology, Zuyderland Medical Centre, Heerlen, the Netherlands.
  • Gu YL; Department of Cardiology, Gelre Hospitals, Apeldoorn-Zutphen, the Netherlands.
  • Luermans JGLM; Department of Cardiology, onze lieve vrouwe gasthuis, Amsterdam, the Netherlands.
  • Kruip MJHA; Department of Cardiology, Hospital Nij Smellinghe, Nij Smellinghe, Drachten, the Netherlands.
  • Timmer SAJ; Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • de Vries TAC; Anticoagulation Clinic, Star-shl, Rotterdam, the Netherlands.
  • Cate HT; Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands.
  • Geersing GJ; Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands.
  • Rutten FH; Department of Cardiology, Hospital Rijnstate, Rijnstate,  Arnhem, the Netherlands.
  • Huisman MV; Department of Cardiology, Amsterdam University Medical Centres location Academic Medical Centre, Amsterdam, the Netherlands.
  • Hemels MEW; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
Eur Heart J Open ; 2(3): oeac022, 2022 May.
Article en En | MEDLINE | ID: mdl-35919339
Aims: To evaluate the extent and determinants of off-label non-vitamin K oral anticoagulant (NOAC) dosing in newly diagnosed Dutch AF patients. Methods and results: In the DUTCH-AF registry, patients with newly diagnosed AF (<6 months) are prospectively enrolled. Label adherence to NOAC dosing was assessed using the European Medicines Agency labelling. Factors associated with off-label dosing were explored by multivariable logistic regression analyses. From July 2018 to November 2020, 4500 patients were registered. The mean age was 69.6 ± 10.5 years, and 41.5% were female. Of the 3252 patients in which NOAC label adherence could be assessed, underdosing and overdosing were observed in 4.2% and 2.4%, respectively. In 2916 (89.7%) patients with a full-dose NOAC recommendation, 4.6% were underdosed, with a similar distribution between NOACs. Independent determinants (with 95% confidence interval) were higher age [odds ratio (OR): 1.01 per year, 1.01-1.02], lower renal function (OR: 0.96 per ml/min/1.73 m2, 0.92-0.98), lower weight (OR: 0.98 per kg, 0.97-1.00), active malignancy (OR: 2.46, 1.19-5.09), anaemia (OR: 1.73, 1.08-2.76), and concomitant use of antiplatelets (OR: 4.93, 2.57-9.46). In the 336 (10.3%) patients with a reduced dose NOAC recommendation, 22.9% were overdosed, most often with rivaroxaban. Independent determinants were lower age (OR: 0.92 per year, 0.88-0.96) and lower renal function (OR: 0.98 per ml/min/1.73 m2, 0.96-1.00). Conclusion: In newly diagnosed Dutch AF patients, off-label dosing of NOACs was seen in only 6.6% of patients, most often underdosing. In this study, determinants of off-label dosing were age, renal function, weight, anaemia, active malignancy, and concomitant use of antiplatelets.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Risk_factors_studies Idioma: En Revista: Eur Heart J Open Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Guideline / Risk_factors_studies Idioma: En Revista: Eur Heart J Open Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido