Guideline-adherent therapy for stroke prevention in atrial fibrillation in different health care settings: Results from RAMSES study

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dc.contributor.authorBaşaran, Özcan
dc.contributor.authorDo?an, Volkan
dc.contributor.authorBiteker, Murat
dc.contributor.authorÖzpamuk Karadeniz, Fatma
dc.contributor.authorTekkeşin, Ahmet İlker
dc.contributor.authorÇakıllı, Yasin
dc.contributor.authorTürkkan, Ceyhan
dc.contributor.authorİnci, Sinan
dc.date.accessioned13.07.201910:50:10
dc.date.accessioned2019-07-16T08:21:41Z
dc.date.available13.07.201910:50:10
dc.date.available2019-07-16T08:21:41Z
dc.date.issued2017
dc.departmentTıp Fakültesi
dc.descriptionPubMed ID: 28238569
dc.description.abstractObjective No studies have been conducted in Turkey to compare the quality of stroke prevention therapies provided in different healthcare settings in patients with atrial fibrillation (AF). Therefore, we aimed to evaluate possible differences between secondary (SH) and tertiary hospital (TH) settings in the effectiveness of implementing AF treatment strategies. Methods Baseline characteristics of 6273 patients with non-valvular AF enrolled in the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke Prevention Strategies in Turkey) study were compared. Results Of the study population, 3312 (52.8%) patients were treated in THs and 2961 (47.2%) patients were treated in SHs. Patients treated in the SH setting were older (70.8 ± 9.8 vs. 68.7 ± 11.4 years, p < 0.001), had a lower socioeconomic status, had a higher CHA2DS2VASc and HASBLED scores (3.4 ± 1.4 vs. 3.1 ± 1.7, p < 0.001 and 1.7 ± 1.0 vs. 1.6 ± 1.1, p < 0.001 respectively), and had more comorbidities than patients treated in THs. Inappropriate oral anticoagulant use was more prevalent in SHs than THs (31.4% vs. 25.6%, p < 0.001). When over- and undertreatment rates were compared among hospital types, overtreatment was more prevalent in THs (7.6% vs. 0.9%, p < 0.001) while undertreatment was more common in SHs (30.5% vs. 17.9%, p < 0.001). Conclusion This study demonstrates the marked disparity between patient groups with AF presenting at SHs and THs. The use of guideline-recommended therapy is not adequate in either type of centre, overtreatment was more prevalent in THs and undertreatment was more prevalent in SHs. © 2017 European Federation of Internal Medicine
dc.identifier.doi10.1016/j.ejim.2017.02.011
dc.identifier.endpage55en_US
dc.identifier.issn0953-6205
dc.identifier.scopusqualityQ1
dc.identifier.startpage50en_US
dc.identifier.urihttps://dx.doi.org/10.1016/j.ejim.2017.02.011
dc.identifier.urihttps://hdl.handle.net/20.500.12451/2299
dc.identifier.volume40en_US
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier B.V.
dc.relation.ispartofEuropean Journal of Internal Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAtrial Fibrillation
dc.subjectGuideline Adherence
dc.subjectOral Anticoagulant Therapy
dc.subjectStroke Prevention
dc.titleGuideline-adherent therapy for stroke prevention in atrial fibrillation in different health care settings: Results from RAMSES study
dc.typeArticle

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