Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) and have better safety profile than vitamin K antagonists (VKAs). However, there is a dearth of quality, real-world, patient data on the use of these dr...

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Autores principales:	Moutaz El Kadri, Ahmed Ghorab, Jean Joury, Mohamed Farghaly, Nancy Awad, Badarinath Chickballapur Ramachandrachar, Ashok Natarajan
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	anticoagulants atrial fibrillation claims healthcare resource utilization noac real-world study Medicine R
Acceso en línea:	https://doaj.org/article/7c7dc832f5144d1db9be9c4dc67412f5
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spelling	oai:doaj.org-article:7c7dc832f5144d1db9be9c4dc67412f52021-12-02T19:02:51ZPatient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database2231-07702249-446410.4103/ajm.ajm_228_20https://doaj.org/article/7c7dc832f5144d1db9be9c4dc67412f52021-04-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.ajm_228_20https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: Non-vitamin K antagonist oral anticoagulants (NOACs) reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) and have better safety profile than vitamin K antagonists (VKAs). However, there is a dearth of quality, real-world, patient data on the use of these drugs to guide healthcare policies in United Arab Emirates (UAE). Aims and Objectives: The aim is to address the knowledge gap in demographic and clinical profiles of NVAF patients on NOACs (apixaban, rivaroxaban, and dabigatran) and warfarin in UAE. Materials and Methods: This retrospective cohort analysis utilized the Dubai Real-World Claims Database to extract anonymized longitudinal data on NVAF patients with at least one NOAC or warfarin claim between January 2015 and March 2019. Data examined included comorbidities, healthcare resource utilization (HCRU), treatment adherence, and clinical events. Results: From 11,086 NVAF patients in the database, 940 patients on oral anticoagulant treatment were selected with mean age of 58.6 ± 14.7 years and 73.7% men. At baseline, the mean CHA2DS2-VASc risk score was 2.4, and the mean Deyo–Charlson comorbidity index (CCI) score was 1.6. Most patients (71%) started oral anticoagulation treatment on a standard index dose. High medication possession ratio (MPR) and proportion of days covered (PDC) were observed in 86.8% and 43.1% of the overall cohort. The mean number of HCRU claims and cost during the 180-day follow-up period was 18.5 and 9,747 USD, respectively. Warfarin users accounted for both the highest number of claims and cost, whereas apixaban accounted for the lowest figures. Time to first major bleeding was shorter for warfarin users compared with patients on NOACs. Longer times to first stroke/systemic embolism (SE) were observed for rivaroxaban and warfarin. Conclusion: This study provides important comparative insights about comorbidities, adherence, HCRU, and outcome events among NOAC and warfarin users from real-world clinical practice settings.Moutaz El KadriAhmed GhorabJean JouryMohamed FarghalyNancy AwadBadarinath Chickballapur RamachandracharAshok NatarajanThieme Medical and Scientific Publishers Pvt. Ltd.articleanticoagulantsatrial fibrillationclaimshealthcare resource utilizationnoacreal-world studyMedicineRENAvicenna Journal of Medicine, Vol 11, Iss 02, Pp 93-102 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anticoagulants atrial fibrillation claims healthcare resource utilization noac real-world study Medicine R
spellingShingle	anticoagulants atrial fibrillation claims healthcare resource utilization noac real-world study Medicine R Moutaz El Kadri Ahmed Ghorab Jean Joury Mohamed Farghaly Nancy Awad Badarinath Chickballapur Ramachandrachar Ashok Natarajan Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
description	Background: Non-vitamin K antagonist oral anticoagulants (NOACs) reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) and have better safety profile than vitamin K antagonists (VKAs). However, there is a dearth of quality, real-world, patient data on the use of these drugs to guide healthcare policies in United Arab Emirates (UAE). Aims and Objectives: The aim is to address the knowledge gap in demographic and clinical profiles of NVAF patients on NOACs (apixaban, rivaroxaban, and dabigatran) and warfarin in UAE. Materials and Methods: This retrospective cohort analysis utilized the Dubai Real-World Claims Database to extract anonymized longitudinal data on NVAF patients with at least one NOAC or warfarin claim between January 2015 and March 2019. Data examined included comorbidities, healthcare resource utilization (HCRU), treatment adherence, and clinical events. Results: From 11,086 NVAF patients in the database, 940 patients on oral anticoagulant treatment were selected with mean age of 58.6 ± 14.7 years and 73.7% men. At baseline, the mean CHA2DS2-VASc risk score was 2.4, and the mean Deyo–Charlson comorbidity index (CCI) score was 1.6. Most patients (71%) started oral anticoagulation treatment on a standard index dose. High medication possession ratio (MPR) and proportion of days covered (PDC) were observed in 86.8% and 43.1% of the overall cohort. The mean number of HCRU claims and cost during the 180-day follow-up period was 18.5 and 9,747 USD, respectively. Warfarin users accounted for both the highest number of claims and cost, whereas apixaban accounted for the lowest figures. Time to first major bleeding was shorter for warfarin users compared with patients on NOACs. Longer times to first stroke/systemic embolism (SE) were observed for rivaroxaban and warfarin. Conclusion: This study provides important comparative insights about comorbidities, adherence, HCRU, and outcome events among NOAC and warfarin users from real-world clinical practice settings.
format	article
author	Moutaz El Kadri Ahmed Ghorab Jean Joury Mohamed Farghaly Nancy Awad Badarinath Chickballapur Ramachandrachar Ashok Natarajan
author_facet	Moutaz El Kadri Ahmed Ghorab Jean Joury Mohamed Farghaly Nancy Awad Badarinath Chickballapur Ramachandrachar Ashok Natarajan
author_sort	Moutaz El Kadri
title	Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
title_short	Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
title_full	Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
title_fullStr	Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
title_full_unstemmed	Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database
title_sort	patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the dubai real-world claims database
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/7c7dc832f5144d1db9be9c4dc67412f5
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Patient characteristics, adherence, and costs of oral anticoagulation therapy in non-valvular atrial fibrillation using the Dubai Real-World Claims Database

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