IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i20p10993-d659964.html
   My bibliography  Save this article

Gender and Socioeconomic Inequality in the Prescription of Direct Oral Anticoagulants in Patients with Non-Valvular Atrial Fibrillation in Primary Care in Catalonia (Fantas-TIC Study)

Author

Listed:
  • Mª Rosa Dalmau Llorca

    (Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
    Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain
    Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Co-first author, these authors, M. Rosa Dalmau Llorca and Carina Aguilar Martín, contributed equally to this work.)

  • Carina Aguilar Martín

    (Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Terres de l’Ebre Research Support Unit, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Catalonia, Spain
    Unitat d’Avaluació, Direcció d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
    Co-first author, these authors, M. Rosa Dalmau Llorca and Carina Aguilar Martín, contributed equally to this work.)

  • Noèlia Carrasco-Querol

    (Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Terres de l’Ebre Research Support Unit, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Catalonia, Spain
    Unitat de Recerca, Gerència Territorial Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain)

  • Zojaina Hernández Rojas

    (Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
    Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain
    Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain)

  • Emma Forcadell Drago

    (Equip d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
    Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain)

  • Dolores Rodríguez Cumplido

    (Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Hospital Universitari de Bellvitge, Institut Català de la Salut, 08907 Barcelona, Catalonia, Spain)

  • Elisabet Castro Blanco

    (Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain
    Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain)

  • Josep Mª Pepió Vilaubí

    (Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain)

  • Alessandra Queiroga Gonçalves

    (Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Terres de l’Ebre Research Support Unit, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Catalonia, Spain
    Unitat Docent de Medicina de Familia i Comunitària, Tortosa-Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain
    Co-senior authors: M. Rosa Dalmau Llorca, Carina Aguilar Martín, Alessandra Queiroga Gonçalves and José Fernández-Sáez. M. Rosa Dalmau Llorca is the Principal Investigator of this study.)

  • José Fernández-Sáez

    (Campus Terres de l’Ebre, Universitat Rovira i Virgili, 43500 Tortosa, Catalonia, Spain
    Primary Care Intervention Evaluation Research Group (GAVINA Research Group), IDIAPJGol Terres de l’Ebre, 43500 Tortosa, Catalonia, Spain
    Terres de l’Ebre Research Support Unit, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 43500 Tortosa, Catalonia, Spain
    Unitat de Recerca, Gerència Territorial Terres de l’Ebre, Institut Català de la Salut, 43500 Tortosa, Catalonia, Spain)

Abstract

Background: Evidence points to unequal access to direct oral anticoagulant (DOAC) therapy, to the detriment of the most socioeconomically disadvantaged patients in different geographic areas; however, few studies have focused on people with atrial fibrillation. This study aimed to assess gender-based and socioeconomic differences in the prescriptions of anticoagulants in people with non-valvular atrial fibrillation who attended Primary Care. Method: A cross-sectional study with real-world data from patients treated in Primary Care in Catalonia (Spain). Data were obtained from the SIDIAP database, covering 287 Primary Care centers in 2018. Results were presented as descriptive statistics and odds ratios estimated by multivariable logistic regression. Results: A total of 60,978 patients on anticoagulants for non-valvular atrial fibrillation were identified: 41,430 (68%) were taking vitamin K antagonists and 19,548 (32%), DOACs. Women had higher odds of treatment with DOAC (adjusted odds ratio [ORadj] 1.12), while lower DOAC prescription rates affected patients from Primary Care centers located in high-deprivation urban centers (ORadj 0.58) and rural areas (ORadj 0.34). Conclusions: DOAC prescription patterns differ by population. Women are more likely to receive it than men, while people living in rural areas and deprived urban areas are less likely to receive this therapy. Following clinical management guidelines could help to minimize the inequality.

Suggested Citation

  • Mª Rosa Dalmau Llorca & Carina Aguilar Martín & Noèlia Carrasco-Querol & Zojaina Hernández Rojas & Emma Forcadell Drago & Dolores Rodríguez Cumplido & Elisabet Castro Blanco & Josep Mª Pepió Vilaubí &, 2021. "Gender and Socioeconomic Inequality in the Prescription of Direct Oral Anticoagulants in Patients with Non-Valvular Atrial Fibrillation in Primary Care in Catalonia (Fantas-TIC Study)," IJERPH, MDPI, vol. 18(20), pages 1-12, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:20:p:10993-:d:659964
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/20/10993/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/20/10993/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Michelle Sholzberg & Tara Gomes & David N Juurlink & Zhan Yao & Muhammad M Mamdani & Andreas Laupacis, 2016. "The Influence of Socioeconomic Status on Selection of Anticoagulation for Atrial Fibrillation," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-12, February.
    2. Andrea Cabezas-Rodríguez & Amaia Bacigalupe & Unai Martín, 2020. "Diagnosis and Treatment of Depression in Spain: Are There Gender Inequalities?," IJERPH, MDPI, vol. 17(24), pages 1-10, December.
    3. M. Rosa Dalmau Llorca & Carina Aguilar Martín & Noèlia Carrasco-Querol & Zojaina Hernández Rojas & Emma Forcadell Drago & Dolores Rodríguez Cumplido & Josep M. Pepió Vilaubí & Elisabet Castro Blanco &, 2021. "Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)," IJERPH, MDPI, vol. 18(5), pages 1-16, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Konsta Teppo & Jussi Jaakkola & Fausto Biancari & Olli Halminen & Miika Linna & Jari Haukka & Jukka Putaala & Pirjo Mustonen & Janne Kinnunen & Alex Luojus & Saga Itäinen-Strömberg & Juha Hartikainen , 2022. "Rural–Urban differences in Use of Rhythm Control Therapies in Patients with Incident Atrial Fibrillation: A Finnish Nationwide Cohort Study," IJERPH, MDPI, vol. 19(18), pages 1-10, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. M. Rosa Dalmau Llorca & Carina Aguilar Martín & Noèlia Carrasco-Querol & Zojaina Hernández Rojas & Emma Forcadell Drago & Dolores Rodríguez Cumplido & Elisabet Castro Blanco & Alessandra Queiroga Gonç, 2021. "Anticoagulation Control with Acenocoumarol or Warfarin in Non-Valvular Atrial Fibrillation in Primary Care (Fantas-TIC Study)," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
    2. Ángel Denche-Zamorano & Víctor Paredes-Mateos & Raquel Pastor-Cisneros & Jorge Carlos-Vivas & Nicolás Contreras-Barraza & José A. Iturra-Gonzalez & María Mendoza-Muñoz, 2022. "Physical Activity Level, Depression, Anxiety, and Self-Perceived Health in Spanish Adults with Migraine: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(21), pages 1-12, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:20:p:10993-:d:659964. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.