The Prescription of Vitamin K Antagonists in a Very Old Population: A Cross-Sectional Study of 8696 Ambulatory Subjects Aged Over 85 Years

Patrick Manckoundia, Clémentine Rosay, Didier Menu, Valentine Nuss, Anca-Maria Mihai, Jérémie Vovelle, Gilles Nuémi, Philippe d’Athis, Alain Putot and Jérémy Barben
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Patrick Manckoundia: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Clémentine Rosay: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Didier Menu: Mutualité Sociale Agricole of Burgundy Franche Comté, 21000 Dijon, France
Valentine Nuss: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Anca-Maria Mihai: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Jérémie Vovelle: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Gilles Nuémi: Department of Medical Information, University Hospital, University of Burgundy, 21000 Dijon, France
Philippe d’Athis: Department of Medical Information, University Hospital, University of Burgundy, 21000 Dijon, France
Alain Putot: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France
Jérémy Barben: Hospital of Champmaillot, University Hospital, University of Burgundy, 21000 Dijon, France

IJERPH, 2020, vol. 17, issue 18, 1-12

Abstract: We compared very elderly people taking vitamin K antagonists (VKA) and those not taking VKA (noVKA). Individuals were included in the noVKA group if there was no VKA on their reimbursed prescriptions during the study period. We also compared three subgroups, constituted by VKA type (fluindione, warfarin, or acenocoumarol). We included individuals aged over 85 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for prescribed VKA in September 2017. The VKA and noVKA groups were compared in terms of demographic conditions, registered chronic diseases (RCD), number of drugs per prescription and cardiovascular medications. The three VKA subgroups were compared for the same items plus laboratory monitoring, novel and refill VKA prescriptions, and prescriber specialty. Of the 8696 included individuals, 1157 (13.30%) were prescribed VKA. Mean age was 90 years. The noVKA group had fewer women (53.67 vs 66.08%), more RCD (93.43 vs. 71.96%) and more drugs per prescription (6.65 vs. 5.18) than the VKA group (all p < 0.01). Except for direct oral anticoagulants and platelet aggregation inhibitors, the VKA group took significantly more cardiovascular medications. The most commonly prescribed VKA was fluindione (59.46%). Mean age was higher in the warfarin (90.42) than in the acenocoumarol (89.83) or fluindione (89.71) subgroups ( p < 0.01). No differences were observed for sex (women were predominant) or RCD. 13% of subjects in this population had a VKA prescription. Fluindione was the most commonly prescribed VKA.

Keywords: aged 80 and over; anticoagulants; drug prescription; outpatients (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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