TY - JOUR T1 - Pattern of oral anticoagulant prescribing for atrial fibrillation in general practice: an observational study in The Netherlands JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2022.0179 VL - 7 IS - 1 SP - BJGPO.2022.0179 AU - Catharina CM Kager AU - Maaike Horsselenberg AU - Joke C Korevaar AU - Cordula Wagner AU - Karin Hek Y1 - 2023/03/01 UR - http://bjgpopen.org/content/7/1/BJGPO.2022.0179.abstract N2 - Background In the Dutch atrial fibrillation (AF) guideline for GPs, vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) are seen as equivalent, while in cardiology there is a preference for DOACs.Aim To describe the pattern of oral anticoagulant (OAC) prescribing for AF by GPs and assess whether GPs proactively convert between VKAs and DOACs in patients with AF.Design & setting Observational study using routine practice data from 214 general practices, from 2017 until 2019.Method Patients aged ≥60 years diagnosed with AF, who had been prescribed OACs by their GPs in 2018 were included. A distinction was made between starters, who were participants who did not use OACs in 2017, and prevalent users. It was observed and recorded whether patients switched between VKAs and DOACs.Results A total of 12 516 patients with AF were included. Four hundred and seventy-six patients (4%) started OACs in 2018; 12 040 patients were prevalent OAC users. When GPs started patients on OACs, DOACs were prescribed the most (88%). Among prevalent users, more than half of the patients used VKAs (60%). GPs switched between OACs for 1% of starters and 0.6% of prevalent users in 2018 and 2019.Conclusion Dutch GPs predominantly start with DOACs in newly diagnosed patients with AF. Prevalent patients predominantly use VKAs and switching from a DOAC to a VKA is unusual. Consequently, the number of patients using VKAs will decline in the upcoming years. This trend raises questions about the future of organising frequent international normalised ratio (INR) checks for VKA users. ER -