Patterns of Medications for Atrial Fibrillation Among Older Women: Results From the Australian Longitudinal Study on Women's Health.

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  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 9602617 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-4034 (Electronic) Linking ISSN: 10742484 NLM ISO Abbreviation: J Cardiovasc Pharmacol Ther Subsets: MEDLINE
    • Publication Information:
      Publication: 2007- : Thousand Oaks, Calif. : Sage Publications
      Original Publication: Naperville, IL : Churchill Livingstone Inc., c1996-
    • Subject Terms:
      Women's Health*; Anti-Arrhythmia Agents/*therapeutic use ; Atrial Fibrillation/*drug therapy ; Drug Utilization/*trends ; Fibrinolytic Agents/*therapeutic use ; Healthcare Disparities/*trends ; Practice Patterns, Physicians'/*trends ; Stroke/*prevention & control ; Thromboembolism/*prevention & control; Aged ; Aged, 80 and over ; Anti-Arrhythmia Agents/adverse effects ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Australia/epidemiology ; Female ; Fibrinolytic Agents/adverse effects ; Humans ; Longitudinal Studies ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke/diagnosis ; Stroke/epidemiology ; Thromboembolism/diagnosis ; Thromboembolism/epidemiology ; Time Factors ; Treatment Outcome
    • Abstract:
      Purpose: Examine patterns of medication use, changes in medication patterns over time, and investigate factors associated with medication patterns among older Australian women with Atrial Fibrillation (AF).
      Methods: It is a retrospective analysis of the 1921-26 birth cohort of the Australian Longitudinal Study on Women's Health (ALSWH), diagnosed with AF between 2000-2015 (N = 1206). Survey data of these women was linked with national registries for medications and death. Latent Transition Analysis (LTA) identified distinct patterns of medication use and transitions among these patterns for 3 consecutive years following AF diagnosis. LTA with co-variates determined the factors associated with latent status membership.
      Results: One-tenth (9.6%, 11.7%, 11.4%) of the study population did not receive any medication for AF in all 3 years following AF diagnosis and about 60% did not receive any medication for the prevention of thromboembolism. Among those who received medications, almost three-quarters (76.6%, 68.4%, 68.5%) received some kind of combination of medications. LTA indicated at least 6 different patterns of AF medications. These patterns had transition probabilities >85% for most of the latent statuses. All factors but diabetes mellitus among the CHA 2 DS 2 -VA scoring scheme were independently associated with latent status membership at the time of AF diagnosis.
      Conclusions: Evaluation of pharmacological treatment indicates that prevention of thromboembolism is inadequate among women with AF. There exists wide variations in medication patterns. However, once in a particular pattern, women are likely to continue the same medications long-term. This underscores the importance of initial assessment of patient profile and stroke risk score in determining the treatment for AF. Failure to assess risk makes women susceptible to devastating AF complications.
    • Contributed Indexing:
      Keywords: 80 and over; aged; atrial fibrillation; latent transition analysis; longitudinal studies; medication patterns; stroke prevention
    • Accession Number:
      0 (Anti-Arrhythmia Agents)
      0 (Fibrinolytic Agents)
    • Publication Date:
      Date Created: 20200808 Date Completed: 20210714 Latest Revision: 20210714
    • Publication Date:
      20240829
    • Accession Number:
      10.1177/1074248420947278
    • Accession Number:
      32757782