AF-React study: atrial fibrillation management strategies in clinical practice—retrospective longitudinal study from real-world data in Northern Portugal

• Main Authors: Susana Silva Pinto, Teresa S Henriques, Hugo Monteiro
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2021-03-01
• Series: BMJ Open
• Online Access: https://bmjopen.bmj.com/content/11/3/e040404.full

Objectives To determine the prevalence of atrial fibrillation (AF) and to assess how these patients are being cared for: what anticoagulants are being prescribed and are they being prescribed as recommended?Design Retrospective longitudinal study.Setting This study was conducted in the Regional Health Administration of Northern Portugal.Participants This study used a database that included 63526 patients with code K78 of the International Classification of Primary Care between January 2016 and December 2018.Results The prevalence of AF among adults over 40 years in the northern region of Portugal was 2.3% in 2016, 2.8% in 2017 and 3% in 2018. From a total of 63 526 patients, 95.8% had an indication to receive anticoagulation therapy. Of these, 44 326 (72.9%) are being treated with anticoagulants: 17 936 (40.5%) were prescribed vitamin K antagonists (VKAs) and 26 390 (59.5%) were prescribed non-VKA anticoagulants. On the other hand, 2688 patients of the total (4.2%) had no indication to receive anticoagulation therapy. Of these 2688 patients, 1100 (40.9%) were receiving anticoagulants.Conclusions The prevalence of AF is 3%. Here, we report evidence of both undertreatment and overtreatment. Although having an indication, a considerable proportion of patients (27.1%) are not anticoagulated, and among patients with AF without an indication to receive anticoagulation therapy, a considerable proportion (40.9%) are receiving anticoagulants. The AF-React study brings extremely relevant conclusions to Portugal and follows real-world studies in patients with AF in Europe, presenting some data not yet studied.