Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients

Trullas-Vila, Joan-Carles; Bisbe-Company, Josep; Freitas-Ramírez, Adriana; Bisbe-Company, Vicenta; Roncero-Vidal, Josep-Maria; Gispert-Magarolas, Rosa

doi:10.1007/s11239-009-0311-9

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…This figure was slightly higher than that of other studies carried out in Spain to date. One study found the average number of visits to be 12.1 [27], although it was conducted over a period of ten years in a rural area. A further study, undertaken in 2003 and included 20,347 patients receiving VKA treatment monitored by four anticoagulation units within large hospitals in Spain, found that the average annual number of visits per patient was 10.42 [17].…”

Section: Discussionmentioning

confidence: 99%

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Direct vitamin k antagonist anticoagulant treatment health care costs in patients with non-valvular atrial fibrillation

Hidalgo

Askari

Vidal

et al. 2014

BMC Health Serv Res

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BackgroundThere is evidence suggesting that most thromboembolic complications could be prevented with adequate pharmacological anticoagulation. We estimated the direct health care costs of anticoagulant treatment with oral vitamin K antagonists in patients diagnosed with non-valvular atrial fibrillation.MethodsThis observational study examined the clinical records of patients diagnosed with non-valvular atrial fibrillation who received anticoagulant treatment with oral vitamin K antagonists. Data from clinical records were used in the study: international normalized ratio, number of monitoring visits, type of anticoagulant, hospital admissions from complications, and concomitant medication. Drug cost was calculated based on the official Spanish Ministry of Health price list. Monitoring expenses were included the cost of the medical supplies used in the procedures. Hospitalization costs were calculated using the Diagnosis Related Group price for each case. Hospital visits costs were calculated by one of four different scenarios, using either the invoice rates for the regional health care authority or cost per visit as established by analytical accounting methods.ResultsWe collected data from 1,257 patients diagnosed with non-valvular atrial fibrillation who were receiving oral anticoagulant therapy. Depending on the scheme used, the direct health care costs for these patients ranged from €423,695 - €1,436,038 per annum. The average cost per patient varied between €392 - €1,341, depending on the approach used. Patients with international normalized ratio values within the therapeutic range on 25% of their visits represented an average cost between €441.70 - €1,592. Those within the therapeutic range on 25%–50% of visits had associated costs of €512.37 - €1,703.91. When international normalized ratio values were within the therapeutic range on 50% - 75% of the visits, the costs ranged between €400.80- €1,375.74. The average cost was €305.23 - €1,049.84 when the values were within the therapeutic range for over 75% of visits.ConclusionsMost direct health care costs associated with the sampled patients arise from the specialist-care monitoring required for the treatment. Good monitoring is inversely related to direct health care costs.

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Section: Discussionmentioning

confidence: 99%

“…In the ten-year follow-up study performed in a cohort of rural patients, the rates were 1.24/100 patients/year for hemorrhage and 0.21/100 patients/year for thrombosis [27]. …”

Section: Discussionmentioning

confidence: 99%

Direct vitamin k antagonist anticoagulant treatment health care costs in patients with non-valvular atrial fibrillation

Hidalgo

Askari

Vidal

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

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Lesiones gastrointestinales y características de las hemorragias digestivas agudas en los pacientes anticoagulados con acenocumarol

Nantes

Zozaya

Montes

et al. 2014

Gastroenterología y Hepatología

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Ischaemic stroke and bleeding rates in ‘real-world’ atrial fibrillation patients

Ogilvie¹,

Welner²,

Cowell³

et al. 2011

Thromb Haemost

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Stroke prevention guidelines recommend oral anticoagulants (OAC) for atrial fibrillation (AF) patients at moderate/high risk of stroke, and antiplatelet or no therapy for those at low/moderate risk. Outcomes for AF patients receiving antiplatelet/no therapy in 'real-life' clinical practice were explored. This study compared clinical event rates (stroke/bleeding) for AF patients treated with OAC therapy, antiplatelets or no therapy in usual clinical practice to event rates in OAC-treated AF patients from optimally-monitored 'real-life' settings (anticoagulation clinics). We searched biomedical literature (1994-2010) using PubMed to identify 'real-world' studies of clinical event rates for AF patients receiving OAC therapy, antiplatelets, or no therapy; event rates were extracted for each treatment and setting. We identified 136 studies of thromboembolic events and 86 of bleeding events. Ischaemic stroke rates (30 studies) were higher for AF patients receiving no therapy (median: 4.45/100 person-years; range: 0.25-5.9) or antiplatelet-therapy (median: 4.45/100 person-years; range: 2.0-10) compared to OAC-treated patients monitored in anticoagulation clinics (median: 1.72/100 person-years; range: 0.97-2.00), or from a non-specialized setting (median 1.66/100 person-years; range: 0-4.9). Major bleeding rates (32 studies) for patients receiving antiplatelet/no therapy were similar to OAC-treated patients from both clinical settings. As in randomised clinical trials, AF patients in 'real-world' clinical practice receiving antiplatelet/no therapy have higher rates of ischaemic stroke than OAC-treated patients. Antiplatelet/no therapy was associated with similar bleeding rates to OAC therapy. Increasing utilisation of anticoagulants in clinical practice could improve patient outcomes.

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Ten-year experience with acenocoumarol treatment in an ambulatory cohort of Spanish patients

Abstract: 2% of our population is receiving acenocoumarol. Incidence of hemorrhagic and thrombotic events was low. Patients with AF and PHV had increased risk of bleeding.

Cited by 4 publications

References 19 publications

Direct vitamin k antagonist anticoagulant treatment health care costs in patients with non-valvular atrial fibrillation

Direct vitamin k antagonist anticoagulant treatment health care costs in patients with non-valvular atrial fibrillation

Lesiones gastrointestinales y características de las hemorragias digestivas agudas en los pacientes anticoagulados con acenocumarol

Ischaemic stroke and bleeding rates in ‘real-world’ atrial fibrillation patients

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