2023
DOI: 10.3389/fphar.2023.1110036
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Sex and gender differences in the use of oral anticoagulants for non-valvular atrial fibrillation: A population-based cohort study in primary health care in catalonia

Abstract: Objectives: To describe the sex and gender differences in the treatment initiation and in the socio-demographic and clinical characteristics of all patients initiating an oral anticoagulant (OAC), and the sex and gender differences in prescribed doses and adherence and persistence to the treatment of those receiving direct oral anticoagulants (DOAC).Material and methods: Cohort study including patients with non-valvular atrial fibrillation (NVAF) who initiated OAC in 2011–2020. Data proceed from SIDIAP, Inform… Show more

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Cited by 5 publications
(10 citation statements)
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“…During the period spanning 2011 to 2020, 123,250 people with NVAF were prescribed a new OAC. Their baseline socio-demographic and clinical characteristics and the persistence and adherence to treatment have been described elsewhere ( Giner-Soriano et al, 2023 ). Of these people, 90,773 (73.6%) received a dispensing for the OAC prescription and were included in the analyses of effectiveness and safety ( Figure 2 ).…”
Section: Resultsmentioning
confidence: 99%
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“…During the period spanning 2011 to 2020, 123,250 people with NVAF were prescribed a new OAC. Their baseline socio-demographic and clinical characteristics and the persistence and adherence to treatment have been described elsewhere ( Giner-Soriano et al, 2023 ). Of these people, 90,773 (73.6%) received a dispensing for the OAC prescription and were included in the analyses of effectiveness and safety ( Figure 2 ).…”
Section: Resultsmentioning
confidence: 99%
“…In this cohort study including 90,773 people with NVAF who initiated OAC between 2011 and 2020 and with up to 10 years of follow-up, we have studied effectiveness and safety of OAC treatment, according to age categories, sex, and the presence of prevalent comorbidities and comedications. We have also investigated these outcomes for people receiving DOAC in terms of dose, adherence and treatment switch, which had not been analysed so far in our setting, although DOAC initiation already accounts for more than 50% of new treatments ( Giner-Soriano et al, 2023 ). To obtain more accurate information on drug intake, we have conducted the analyses in the cohort of patients with OAC dispensed rather than relying solely on prescription data ( Grégoire and Moisan, 2016 ).…”
Section: Discussionmentioning
confidence: 99%
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“…The reasons for this discrepancy are not entirely clear but we do know that a history of minor bleeding is associated with NOAC underdosing ( Caso et al , 2023) and women tend to present more frequently with adverse drug reactions such as this (Giner-Soriano et al , 2023 ). It may also be due to renal function assessment; using eGFR rather than creatinine clearance can overestimate renal function in females (Howard et al , 2017 ).…”
Section: Discussionmentioning
confidence: 99%
“…First, data on OAC adherence or label-adherent prescribing were lacking, especially since females tended to have higher rates of NOAC underdosing than males. 11 Second, the study did not account for residential or other precise socioeconomic status data, although they included some data about income. In particular, the sex disparity in NOAC use was greater in rural or highly deprivation areas.…”
Section: Sex Disparities For Patients With Atrial Fibrillation the Di...mentioning
confidence: 99%