Gender and Socioeconomic Inequality in the Prescription of Direct Oral Anticoagulants in Patients with Non-Valvular Atrial Fibrillation in Primary Care in Catalonia (Fantas-TIC Study)

Rosa Dalmau Llorca Mª, Carina Aguilar Martín, Noèlia Carrasco-Querol, Zojaina Hernández Rojas, Emma Forcadell Drago, Dolores Rodríguez Cumplido, Elisabet Castro Blanco, Josep Mª Pepió Vilaubí, Alessandra Queiroga Gonçalves and José Fernández-Sáez
Additional contact information
Rosa Dalmau Llorca Mª: Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
Carina Aguilar Martín: Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
Noèlia Carrasco-Querol: Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
Zojaina Hernández Rojas: Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
Emma Forcadell Drago: Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
Dolores Rodríguez Cumplido: Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
Elisabet Castro Blanco: Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain
Josep Mª Pepió Vilaubí: Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
Alessandra Queiroga Gonçalves: Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
José Fernández-Sáez: Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain

IJERPH, 2021, vol. 18, issue 20, 1-12

Abstract: Background: Evidence points to unequal access to direct oral anticoagulant (DOAC) therapy, to the detriment of the most socioeconomically disadvantaged patients in different geographic areas; however, few studies have focused on people with atrial fibrillation. This study aimed to assess gender-based and socioeconomic differences in the prescriptions of anticoagulants in people with non-valvular atrial fibrillation who attended Primary Care. Method: A cross-sectional study with real-world data from patients treated in Primary Care in Catalonia (Spain). Data were obtained from the SIDIAP database, covering 287 Primary Care centers in 2018. Results were presented as descriptive statistics and odds ratios estimated by multivariable logistic regression. Results: A total of 60,978 patients on anticoagulants for non-valvular atrial fibrillation were identified: 41,430 (68%) were taking vitamin K antagonists and 19,548 (32%), DOACs. Women had higher odds of treatment with DOAC (adjusted odds ratio [ORadj] 1.12), while lower DOAC prescription rates affected patients from Primary Care centers located in high-deprivation urban centers (ORadj 0.58) and rural areas (ORadj 0.34). Conclusions: DOAC prescription patterns differ by population. Women are more likely to receive it than men, while people living in rural areas and deprived urban areas are less likely to receive this therapy. Following clinical management guidelines could help to minimize the inequality.

Keywords: direct oral anticoagulants; vitamin K antagonists; atrial fibrillation; socioeconomic inequalities; sex-related differences (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/20/10993/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/20/10993/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:20:p:10993-:d:659964

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().