Anticoagulant Utilization Pattern
26 mars 2019 uppdaterad av: Boehringer Ingelheim
A Description of Warfarin and NOAC Utilization Patterns Including Initiation, Switching, and Discontinuation
This study plans to describe utilization patterns for oral anticoagulants over time in patients with non-valvular atrial fibrillation at risk for stroke using electronic claims data from a United States commercial insurance database.
Studieöversikt
Status
Avslutad
Betingelser
Studietyp
Observationell
Inskrivning (Faktisk)
333664
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Massachusetts
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Boston, Massachusetts, Förenta staterna, 02120
- Brigham and Women's Hospital
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Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år och äldre (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Testmetod
Icke-sannolikhetsprov
Studera befolkning
Patients 18 years of age and older with non-valvular AF at risk for stroke treated with oral anticoagulation
Beskrivning
Inclusion criteria:
- A recorded diagnosis of atrial fibrillation
- Initiation of oral anticoagulant medication
- Congestive Heart Failure, Hypertension, Age > 75, Diabetes Mellitus, Prior Stroke or Transient Ischemic Attack, Vascular Disease, Age 65-74, Sex Category (CHA2DS2-VASc) Score >=1
- At least 18 years of age on the date of anticoagulant initiation
Exclusion criteria:
- Patients with missing or ambiguous age or sex information
- Patients with documented evidence of valvular disease
- Patients with less than 12 months enrolment in the UnitedHealth Research Database preceding the first dispensing
- Patients with prior use of any oral anticoagulant
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
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Dabigatran
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Warfarin or other New Oral Anticoagulant (NOAC)
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Description of the Characteristics of Anticoagulant Initiators
Tidsram: From January 2009 to September 2015 (The study period)
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The analyses described the characteristics of patients treated with various oral anticoagulants.
CHA2DS2-VASc stroke risk score is calculated based on the following conditions: Congestive heart failure/ Left ventricular (LV) dysfunction, Hypertension, Age (≥ 75), Diabetes Mellitus, Stroke/ transient ischemic attack (TIA) /thromboembolism, Vascular disease, Age 65-74, female gender.
HAS-BLED bleeding risk score is calculated based on the following conditions: Hypertension, Abnormal renal and liver function, Stroke (1 point), Bleeding history or predisposition, Labile international normalized ratio (INR), Elderly (>65 years), Drugs and Alcohol.
CHA2DS2-VASc stroke risk score may range from 0 to 9 with 0 being the best outcome.
HAS-BLED bleeding risk score may range from 0 to 9 with 0 being the best outcome.
New initiators of warfarin before Dabigatran became available were only characterized in terms of age and sex (results provided above).
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From January 2009 to September 2015 (The study period)
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Percentage of Patients Initiating Specific Anticoagulant
Tidsram: From January 2009 to September 2015 (The study period)
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Proportion of patients initiating specific anticoagulant over time per arm in source cohort is estimated and is expressed in percentage.
This is related to UnitedHealth database and no treatment initiation rate was estimated in MarketScan as the study cohort was defined from a population of oral anticoagulants users.
The overall number of participants analyzed "609201" reported for each of the treatment arm below corresponds to overall patients numbers in UnitedHealth for the entire study period rather than for each of the treatment arm.
Likewise the number of participants for each of the treatment arm for different time period corresponds to the total number of participants for the specific study period rather than for each of the treatment arm.
Incident users at given time period could also be counted in later time period if the patient discontinued the drug and had re-entry during the study period.
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From January 2009 to September 2015 (The study period)
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Percentage of Patients Initiating Specific Anticoagulant Dose - Dabigatran
Tidsram: From January 2009 to September 2015 (The study period)
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Percentage of patients initiating specific anticoagulant dose of dabigatran across all time periods combined in the unmatched cohort for UnitedHealth and MarketScan cohort are presented.
Proportion of patients initiating specific anticoagulant over time per arm in source cohort is estimated and is expressed in percentage.
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From January 2009 to September 2015 (The study period)
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Percentage of Patients Initiating Specific Anticoagulant Dose - Apixaban
Tidsram: From January 2009 to September 2015 (The study period)
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Percentage of patients initiating specific anticoagulant dose of apixaban across all time periods combined in the unmatched cohort for UnitedHealth and MarketScan cohort are presented.
Proportion of patients initiating specific anticoagulant over time per arm in source cohort is estimated and is expressed in percentage.
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From January 2009 to September 2015 (The study period)
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Percentage of Patients Initiating Specific Anticoagulant Dose - Rivaroxaban
Tidsram: From January 2009 to September 2015 (The study period)
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Percentage of patients initiating specific anticoagulant dose of rivaroxaban across all time periods combined in the unmatched cohort for UnitedHealth and MarketScan cohort are presented.
Proportion of patients initiating specific anticoagulant over time per arm in source cohort is estimated and is expressed in percentage.
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From January 2009 to September 2015 (The study period)
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Treatment Persistence Over Time
Tidsram: From January 2009 to September 2015 (The study period)
|
Overall treatment persistence in UnitedHealth and MarketScan cohorts are presented as the percentage of patients who were persistent to treatment after 3, 6 and 12 months of follow-up for all time periods combined and matched cohort.
Based on two US-based longitudinal healthcare claims databases (MarketScan and unitedHealth Research Database) the three separate study cohorts warfarin vs dabigatran, warfarin vs rivaroxaban and warfarin vs apixaban cohort were formed for each database.
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From January 2009 to September 2015 (The study period)
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Sponsor
Publikationer och användbara länkar
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Användbara länkar
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Faktisk)
17 april 2013
Primärt slutförande (Faktisk)
1 november 2017
Avslutad studie (Faktisk)
1 november 2017
Studieregistreringsdatum
Först inskickad
18 april 2013
Först inskickad som uppfyllde QC-kriterierna
2 maj 2013
Första postat (Uppskatta)
7 maj 2013
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
27 juni 2019
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
26 mars 2019
Senast verifierad
1 mars 2019
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- 1160.177
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .