Roldan, Vanessa, Martinez-Montesinos, Lorena, Lopez-Galvez, Raquel, Garcia-Tomas, Lucia, Lip, Gregory YH 
ORCID: 0000-0002-7566-1626, Miguel Rivera-Caravaca, Jose and Marin, Francisco
(2022)
Relation of the 'Atrial Fibrillation Better Care (ABC) Pathway' to the Quality of Anticoagulation in Atrial Fibrillation Patients Taking Vitamin K Antagonists.
JOURNAL OF PERSONALIZED MEDICINE, 12 (3).
487-.
Abstract
The Atrial Fibrillation Better Care (ABC) pathway was proposed for a more integrated atrial fibrillation (AF) care. We investigated if adherence to the ABC pathway was associated to the quality of anticoagulation control in a cohort of AF outpatients starting vitamin K antagonists (VKAs) between July 2016 and June 2018. Patients were considered adherent to the ABC pathway if they met all of its components. The time in therapeutic range (TTR) was estimated at one year. In total, 1045 patients (51.6% female; median age 77 years; 63% ABC pathway adherent) were included. At one year, 474 (51.6%) of 919 patients with international normalized ratio (INR) data for TTR estimation had a TTR < 65%. Among ABC pathway non-adherent patients, a greater proportion had TRT < 65% (56.4% vs. 43.6%, p = 0.025), and TTR < 70% (64.9% vs. 35.1%, p = 0.033), with lower mean TTR in non-adherent patients (59.4 ± 22.3% vs. 63.9 ± 21.1%; p = 0.004). Logistic regression models demonstrated that the ABC pathway adherence in its continuous (aOR: 0.75, 95% CI 0.59−0.96) and categorical (aOR: 0.75, 95% CI 0.57−0.98) forms was independently associated with TTR ≥ 65%. In this ‘real-world’ cohort of AF patients starting VKAs, the ABC pathway adherent patients had better TTR, and more ABC criteria fulfilled increased the probability of achieving good TTR.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | atrial fibrillation, vitamin K antagonists, time in therapeutic range, Atrial Fibrillation Better Care (ABC) pathway |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Faculty Management Office Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 13 May 2022 14:52 |
| Last Modified: | 14 Mar 2023 19:28 |
| DOI: | 10.3390/jpm12030487 |
| Open Access URL: | https://www.mdpi.com/2075-4426/12/3/487 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3154762 |
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