fibrilacion auricular: papel de atención primaria
Post on 29-Jan-2018
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Role of primary care in diagnosis and monitoring of non-valvular atrial fibrillation over 5 year
Francisca Rivera
Laura Pérez
Laia Bort
María Moscardó
Silvia Pérez
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Objective & Design
Results: DescriptivePlaying with numbersConclusions
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Objective
• To evaluate the treatment and monitoring of the patients aged 18 or more, with chronic non-valvular atrial fibrilation (NVAF) in a spanish Health Center over 5 years.
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Workflow
• Permission from the Clinical Research Ethics Committee
• Obtaining patients diagnosed with NVAF for each doctor list▪ ICD-codes reviewed:
✓ 427: Cardiac dysrhythmia✓ V58.61: Using long-term anticoagulant
• Reviewing of electronic records with retrospective data collection from 2010 to 2014
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Design of the study
Results: Descriptive
Playing with numbersConclusions
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224 pacients with NVAF
Age: 79.5 yearsFrom 36 to 98 years
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International Normalized Ratio
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Treatment: Antiplatelet
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Treatment: Vitamin K Antagonists
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Treatment: New oral anticoagulants(dabigatran, rivaroxaban, apixaban…)
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Treatment: Antiarrhythmics
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Treatment: Digital
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Use of health services
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Bleedings & Stroke incidence on anticoagulated
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Design of the studyResults: Descriptive
Playing with numbers
Conclusions
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Patients with high stroke risk scorehigh stroke risk score… have more Emergency visits / hospitalizations?
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More stroke risk, more VKA?
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(p=0
,66)
(p=0
,49)
(p=
0,63
)
(p=0
,25)
(p=0
,66)
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Patients with VKAwith VKA…have more Emergency visits?
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p=0.09 p=0.08 p=0.44 p=0.18 p=0.15
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p=0.15 p=0.66 p=0.66 p=0.20 p=0.15
Patients with VKAwith VKA…have more hospitalizations?
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p=0.59 p=0.83 p=0.36 p=0.37 p=0.32 www.csfuensan
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p=0.003 p=0.21 p=0.008 p=0.81 p=0.43
Patients with unstable INRunstable INR…have more visits in emergency?
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p=0.24 p=0.34 p=0.24 p=0.37 p=0.59 p=0.05 p=0.13 p=0.005 p=0.62 p=0.78
Patients with unstable INRunstable INR… have more hospitalizations?
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p=0.04 p=0.55 p=0.06 p=0.26 p=0.89 p=0.003 p=0.54 p=0.48 p=0.31 p=0.06
Patients with unstable INRunstable INR… have more consultations with GP/Cardiologist?
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p=0.19 p=0.21 p=0.21 p=0.42 p=0.37
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p=0.11 p=0.47 p=0.05 p=0.33 p=0.50
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Design of the studyResults: DescriptivePlaying with numbers
Conclusions
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We think that...
• GPs have an important role in ▪ Diagnosis▪ Treatment of NVAF
• We are not so involved in monitoring
• It’s important to join in the control of INR of anticoagulated patients from the Primary Care
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