Abstract
To assess patterns and predictors of discontinuation of rhythm-control drug therapy in managed care patients with newly diagnosed atrial fibrillation and the direct medical costs of atrial fibrillation in these patients. Retrospective cohort study. PharMetrics Patient-Centric Database. A total of 3549 adults with a new diagnosis of atrial fibrillation between April 1, 2002, and March 31, 2006, and who had at least one claim for rhythm-control drug therapy within 6 months of the initial diagnosis. Discontinuation (defined as a gap in rhythm-control drug therapy coverage [days' supply] > or = 30 days) was assessed after the initiation of rhythm-control therapy. Among the 3549 patients included in the analysis, 2688 (75.7%) discontinued initial rhythm-control therapy in the first 12 months, with a median time to discontinuation of 89 days. Significant predictors of rhythm-control therapy discontinuation included cardiac arrest (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.04-4.83), history of coronary artery bypass graft surgery (OR 2.03, 95% CI 1.02-4.05), valvular heart disease (OR 1.67, 95% CI 1.33-2.09), ischemic heart disease (OR 1.44, 95% CI 1.13-1.82), and severity of illness (Charlson Comorbidity Index score; OR 1....Continue Reading
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