Patterns and predictors of discontinuation of rhythm-control drug therapy in patients with newly diagnosed atrial fibrillation

Pharmacotherapy
M H KimD Battleman

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

References

Aug 10, 1989·The New England Journal of Medicine·UNKNOWN Cardiac Arrhythmia Suppression Trial (CAST) Investigators
Aug 10, 1989·The New England Journal of Medicine·J N Ruskin
Apr 23, 2002·British Journal of Clinical Pharmacology·John LarsenLars F Gram
Jun 21, 2002·Circulation Journal : Official Journal of the Japanese Circulation Society·Tsuyoshi ShigaHiroshi Kasanuki
Dec 6, 2002·The New England Journal of Medicine·D G WyseUNKNOWN Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators
Dec 31, 2002·The American Journal of Cardiology·Peter ZimetbaumUNKNOWN FRACTAL Investigators
Nov 3, 2004·Annals of Internal Medicine·Deborah A MarshallUNKNOWN AFFIRM and CORE Investigators
Sep 12, 2006·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Karin S CoynePeter Zimetbaum
Sep 13, 2006·The Journal of Clinical Psychiatry·Trent P McLaughlinRaj Tummala
Oct 13, 2006·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David A MacDougallJay Lin
Apr 25, 2007·Journal of Cardiovascular Electrophysiology·Matthew R ReynoldsDavid J Cohen
Feb 28, 2008·Current Medical Research and Opinion·Nancy S Breekveldt-PostmaRon M C Herings
Aug 30, 2008·The American Journal of Cardiology·Yoko MiyasakaTeresa S M Tsang

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Citations

Dec 16, 2011·Advances in Therapy·Marc Cohen, Catalin Boiangiu
Feb 28, 2013·PharmacoEconomics·Bernd BrüggenjürgenStefan N Willich
Jun 12, 2012·The Journal of Cardiovascular Nursing·Marilyn A Prasun
Nov 28, 2012·American Journal of Therapeutics·Alpesh N AminJay Lin
Apr 14, 2012·ClinicoEconomics and Outcomes Research : CEOR·Steven N Singh
Mar 22, 2012·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Walter P WodchisDante Morra
Mar 27, 2012·European Journal of Preventive Cardiology·Ghassan MoubarakAlexis Mechulan
Jul 23, 2014·Expert Review of Pharmacoeconomics & Outcomes Research·Christian Becker

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