Role of primary care in diagnosis and monitoring of non-valvular atrial fibrillation over 5 year

Francisca Rivera

Laura Pérez

Laia Bort

María Moscardó

Silvia Pérez

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Objective & Design

Results: DescriptivePlaying with numbersConclusions

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Objective

• To evaluate the treatment and monitoring of the patients aged 18 or more, with chronic non-valvular atrial fibrilation (NVAF) in a spanish Health Center over 5 years.

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Workflow

• Permission from the Clinical Research Ethics Committee

• Obtaining patients diagnosed with NVAF for each doctor list▪ ICD-codes reviewed:

✓ 427: Cardiac dysrhythmia✓ V58.61: Using long-term anticoagulant

• Reviewing of electronic records with retrospective data collection from 2010 to 2014

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Design of the study

Results: Descriptive

Playing with numbersConclusions

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224 pacients with NVAF

Age: 79.5 yearsFrom 36 to 98 years

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International Normalized Ratio

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Treatment: Antiplatelet

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Treatment: Vitamin K Antagonists

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Treatment: New oral anticoagulants(dabigatran, rivaroxaban, apixaban…)

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Treatment: Antiarrhythmics

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Treatment: Digital

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Use of health services

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Bleedings & Stroke incidence on anticoagulated

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Design of the studyResults: Descriptive

Playing with numbers

Conclusions

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Patients with high stroke risk scorehigh stroke risk score… have more Emergency visits / hospitalizations?

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More stroke risk, more VKA?

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(p=0

,66)

(p=0

,49)

(p=

0,63

)

(p=0

,25)

(p=0

,66)

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Patients with VKAwith VKA…have more Emergency visits?

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p=0.09 p=0.08 p=0.44 p=0.18 p=0.15

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p=0.15 p=0.66 p=0.66 p=0.20 p=0.15

Patients with VKAwith VKA…have more hospitalizations?

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p=0.59 p=0.83 p=0.36 p=0.37 p=0.32 www.csfuensan

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p=0.003 p=0.21 p=0.008 p=0.81 p=0.43

Patients with unstable INRunstable INR…have more visits in emergency?

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p=0.24 p=0.34 p=0.24 p=0.37 p=0.59 p=0.05 p=0.13 p=0.005 p=0.62 p=0.78

Patients with unstable INRunstable INR… have more hospitalizations?

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p=0.04 p=0.55 p=0.06 p=0.26 p=0.89 p=0.003 p=0.54 p=0.48 p=0.31 p=0.06

Patients with unstable INRunstable INR… have more consultations with GP/Cardiologist?

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p=0.19 p=0.21 p=0.21 p=0.42 p=0.37

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p=0.11 p=0.47 p=0.05 p=0.33 p=0.50

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Design of the studyResults: DescriptivePlaying with numbers

Conclusions

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We think that...

• GPs have an important role in ▪ Diagnosis▪ Treatment of NVAF

• We are not so involved in monitoring

• It’s important to join in the control of INR of anticoagulated patients from the Primary Care

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