Background: The COVID-19 pandemic disrupted healthcare delivery, impacting oral anticoagulants (OAC) prescribing due to increased thromboembolic risks, Vaccine-induced immune thrombotic thrombocytopenia, and guidelines favoring Direct Oral Anticoagulants (DOACs) over warfarin. Previous studies were limited to short-term analyses.
Research Design And Methods: A segmented interrupted time series analysis was conducted using the English primary care Prescription Cost Analysis data from March/2018-March/2024 to assess the impact of the first and second COVID-19 lockdowns in March and November 2020, respectively. Trends in OAC utilisation were measured using number of items per 1,000 inhabitants (NIT) and defined daily dose per 1,000 inhabitants per day (DTD).
Results: Overall, oral anticoagulants prescribing increased significantly. Pre-pandemic, both NIT (β: 0.09; 95%CI: 0.02, 0.16) and DTD (β:0.13; 95%CI: 0.09, 0.16) showed positive trends. Post-first lockdown, DTD slope declined significantly (β:-0.22; 95%CI: -0.42, -0.03). Post-second lockdown, DTD rose in both immediate level (β:1.39; 95%CI: 0.34, 2.45) and slope (β: 0.20; 95%CI: 0.0015, 0.39). Warfarin usage declined initially but rebounded, while DOACs, particularly apixaban, increased substantially (β:0.96; 95%CI: 0.11, 1.81).
Conclusions: The COVID-19 pandemic significantly impacted oral anticoagulant prescribing patterns in England. While DOAC utilisation continued to rise, warfarin use declined significantly post-first lockdown but rebounded after the second lockdown.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/17512433.2025.2473613 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association.
Europace
March 2025
Clinical Cardiac Academic Group, Genetic and Cardiovascular Sciences Institute, City-St George's University of London, London, UK.
Atrial fibrillation (AF) is one of the most common cardiac diseases and a complicating comorbidity for multiple associated diseases. Many clinical decisions regarding AF are currently based on the binary recognition of AF being present or absent with the categorical appraisal of AF as continued or intermittent. Assessment of AF in clinical trials is largely limited to the time to (first) detection of an AF episode.
View Article and Find Full Text PDFStatins as an Adjunctive Antithrombotic Agent in Thrombotic Antiphospholipid Syndrome: Mechanisms and Clinical Implications.
Cells
February 2025
Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy.
The thrombotic physiopathology of antiphospholipid syndrome (APS) is complex, heterogeneous, and dynamic. While venous thromboembolism (VTE) is the most common initial presentation, arterial thrombotic events (ATE) become more frequent in advanced stages and are associated with high morbidity and mortality. Despite the use of oral anticoagulants (OACs), thrombotic APS remains associated with a high risk of recurrent thrombosis.
View Article and Find Full Text PDFThe utility of coagulation factor testing in non-anticoagulated elderly patients presenting with low-risk mechanical falls in the emergency department.
Am J Emerg Med
February 2025
Department of Emergency Medicine, Good Samaritan University Hospital, West Islip, NY, United States. Electronic address:
Introduction: Data on the utility of coagulation factor testing (INR, aPTT) in non-anticoagulated patients with low-risk trauma is limited. In this study, we describe the rate in which coagulation studies are ordered this population and report the frequency in which these tests were abnormal and resulted in intervention.
Methods: This was a multi-center retrospective observational study evaluating patients aged 65 years and older with low-risk mechanical falls not on chronic oral anticoagulation.
Results of rapid plasma direct oral anticoagulant levels greatly expand stroke thrombolysis eligibility: evidence from real-world implementation.
Intern Med J
March 2025
Department of Neurosciences, Eastern Health, Melbourne, Victoria, Australia.
Direct oral anticoagulants (DOACs) are used for stroke prevention in atrial fibrillation, but their presence can limit thrombolysis eligibility in acute stroke. This retrospective study examined whether rapid plasma DOAC testing expanded eligibility for thrombolysis. Among ischaemic stroke patients taking DOACs who were otherwise eligible for thrombolysis, 40% had low DOAC levels (<50 ng/mL).
View Article and Find Full Text PDFGastric siderosis: an endoscopic diagnosis challenge.
Rev Esp Enferm Dig
March 2025
Gastroenterology and Endoscopy, Hospital Clínic Barcelona, Spain.
A 71-year-old man presented for a routine physical examination with multiple comorbidities, including severe panvascular disease and valvulopathy, requiring anticoagulation therapy. He had a history of chronic hemolytic anemia and had been taking oral ferrous sulfate for two years. Upper gastrointestinal endoscopy (UGE) was performed, as part of the study of the persist anemia, revealing an extensive nodular area with multiple brownish deposits and spontaneous hemorrhage.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!