Document Detail

Pharmacotherapy in Medicare beneficiaries with atrial fibrillation.
MedLine Citation:
PMID:  22537885     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are limited data regarding national patterns of pharmacotherapy for atrial fibrillation (AF) among older patients. Drug exposure data are now captured for Medicare beneficiaries enrolled in prescription drug plans.
OBJECTIVE: To describe pharmacotherapy for AF among Medicare beneficiaries.
METHODS: By using a 5% national sample of Medicare claims data, we compared demographic characteristics, comorbidity, and treatment patterns according to Medicare Part D status among patients with prevalent AF in 2006 and 2007.
RESULTS: In 2006, 27,174 patients (29.3%) with prevalent AF were enrolled in Medicare Part D. In 2007, enrollment increased to 45,711 (49.1%). Most enrollees were taking rate-control agents (74.0% in 2007). β-Blocker use was higher in those with concomitant AF and heart failure and increased with higher CHADS(2) scores (P <.001). Antiarrhythmic use was 18.7% in 2006 and 19.1% in 2007, with amiodarone accounting for more than 50%. Class Ic drugs were used in 3.2% of the patients in 2007. Warfarin use was <60% and declined with increasing stroke risk (P <.001).
CONCLUSION: Pharmacotherapy for AF varied according to comorbidity and underlying risk. Amiodarone was the most commonly prescribed antiarrhythmic agent. Postmarketing surveillance using Medicare Part D claims data linked to clinical data may help inform comparative safety, effectiveness, and net clinical benefit of drug therapy for AF in older patients in real-world settings.
Jonathan P Piccini; Xiaojuan Mi; Tracy A DeWald; Alan S Go; Adrian F Hernandez; Lesley H Curtis
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2012-04-24
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  9     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2013-01-29     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1403-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Heart Rhythm Society. All rights reserved.
Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Aged, 80 and over
Amiodarone / therapeutic use
Anti-Arrhythmia Agents / therapeutic use*
Anticoagulants / therapeutic use
Atrial Fibrillation / drug therapy*,  epidemiology
Calcium Channel Blockers / therapeutic use
Heart Rate
Medicare Part D*
United States / epidemiology
Grant Support
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 0/Anticoagulants; 0/Calcium Channel Blockers; 1951-25-3/Amiodarone

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