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Persistence on warfarin in patients with atrial fibrillation: experience in Australia 2006-2009

Leon A Simons1, Michael Ortiz, Peter Germanos

  • 1MD, FRACP, is Associate Professor of Medicine and Director, Lipid Research Department, University of New South Wales, St Vincent's Hospital, New South Wales.

Australian Family Physician
|September 12, 2013
PubMed

Insights

Warfarin persistence is low in Australian atrial fibrillation patients, with many discontinuing therapy. This significantly reduces opportunities for preventing stroke and other thromboembolic events.

Area of Science:

  • Pharmacotherapy
  • Cardiology
  • Public Health

Background:

  • Long-term warfarin persistence is crucial for minimizing thromboembolic complications in non-valvular atrial fibrillation.
  • This study investigates warfarin persistence in Australian patients newly prescribed the anticoagulant for atrial fibrillation.

Purpose of the Study:

  • To examine the persistence rates of warfarin therapy in a cohort of Australian patients with non-valvular atrial fibrillation.
  • To identify the extent of warfarin discontinuation and its implications for stroke prevention.

Main Methods:

  • A longitudinal analysis of Pharmaceutical Benefit Scheme (PBS) prescription data was conducted.
  • The study included a 10% random sample of Australian concession cardholders from October 2006 to September 2009.

Main Results:

  • 1,108 patients newly prescribed warfarin were analyzed (nationally representative of 11,080).
  • 15% failed to fill their first repeat prescription; median persistence was 12 months.
  • Long-term persistence at 33 months was only 26%.

Conclusions:

  • Significant discontinuation of warfarin therapy was observed in the studied population.
  • Failure to maintain warfarin compliance represents a missed opportunity for effective stroke prevention.
Abstract

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