Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2007-1-18
pubmed:abstractText
The objective of the EXAMINE-AF study was to record and compare antithrombotic treatment in patients with atrial fibrillation (AF) in daily clinical practice of general practitioners, internists and cardiologists in the Netherlands. Eighty-six general practitioners, 93 internists and 99 cardiologists responded to postal questionnaires and enrolled 1596 patients: 365, 351 and 880 respectively. A cardiologist was indicated to be the main treating physician for AF in 82% of all patients; current antithrombotic treatment was initiated in 80% by a cardiologist. Of all patients, 84% were at high risk for stroke and therefore were eligible for oral anticoagulation treatment, but only 64% actually received this. Cardiologists instituted appropriate antithrombotic treatment best, compared with general practitioners and internists (70% vs. 58% and 55%; p < 0.001). Positive predictive factors for oral anticoagulation prescription were previous stroke/transient ischaemic attack (OR, 2.31; 95% CI, 1.33-4.02) and heart failure (OR, 1.72; 95% CI, 1.23-2.42). Contraindications for oral anticoagulation (OR, 0.46; 95% CI, 0.32-0.68), treatment by a general practitioner (OR, 0.29; 95% CI, 0.20-0.42) or internist (OR, 0.24; 95% CI, 0.15-0.39) were important factors for withholding treatment. Antithrombotic treatment in AF patients is well instituted in primary and secondary care in the Netherlands. Cardiologists play a key role in the diagnosis and management of the majority of AF patients, even in those regularly attending other physicians. Factors for oral anticoagulation prescription are heart failure, physician specialty and contraindications. Availability of guidelines seems instrumental for application of appropriate antithrombotic treatment.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1368-5031
pubmed:author
pubmed:issnType
Print
pubmed:volume
61
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
24-31
pubmed:dateRevised
2008-11-21
pubmed:meshHeading
pubmed-meshheading:17229177-Adolescent, pubmed-meshheading:17229177-Adult, pubmed-meshheading:17229177-Aged, pubmed-meshheading:17229177-Atrial Fibrillation, pubmed-meshheading:17229177-Attitude of Health Personnel, pubmed-meshheading:17229177-Cardiology, pubmed-meshheading:17229177-Drug Prescriptions, pubmed-meshheading:17229177-Family Practice, pubmed-meshheading:17229177-Female, pubmed-meshheading:17229177-Fibrinolytic Agents, pubmed-meshheading:17229177-Guideline Adherence, pubmed-meshheading:17229177-Humans, pubmed-meshheading:17229177-Internship and Residency, pubmed-meshheading:17229177-Male, pubmed-meshheading:17229177-Middle Aged, pubmed-meshheading:17229177-Netherlands, pubmed-meshheading:17229177-Practice Guidelines as Topic, pubmed-meshheading:17229177-Questionnaires, pubmed-meshheading:17229177-Risk Factors
pubmed:year
2007
pubmed:articleTitle
Antithrombotic drug prescription in atrial fibrillation and its rationale among general practitioners, internists and cardiologists in The Netherlands--The EXAMINE-AF study. A questionnaire survey.
pubmed:affiliation
Department of Cardiology, University Hospital Maastricht, Maastricht, The Netherlands. t.dinh@cardio.azm.nl
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't