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Steven Almany, M.D. (In Memoriam)
Article
Sociodemographic factors in patients continuing warfarin vs those transitioning to direct oral anticoagulants
Blood Advances (2017)
  • Jordan K. Schaefer, Division of Hematology/Oncology and
  • Suman L. Sood, Division of Hematology/Oncology and
  • Brian Haymart, University of Michigan
  • Xiaokui Gu, University of Michigan
  • Xiaowen Kong, University of Michigan
  • Eva Kline-Rogers, University of Michigan
  • Steven Almany, Beaumont Health
  • Jay Kozlowski, Huron Valley Sinai Hospital, Commerce Township, MI; and
  • Gregory D. Krol, Henry Ford Hospital
  • Scott Kaatz, Henry Ford Hospital
  • James B. Froehlich, University of Michigan
  • Geoffrey D. Barnes, University of Michigan
Link
Abstract
Clinical factors and patient preferences are important for selecting oral anticoagulants for venous thromboembolism (VTE) and atrial fibrillation (AF). The relative association of sociodemographic factors with anticoagulant use is unknown. We evaluated a prospective cohort to compare sociodemographic variables in patients who continued on warfarin for AF or VTE to those who transitioned to 1 of the direct oral anticoagulants (DOACs). Adult patients, newly started on warfarin, were enrolled through 6 anticoagulation clinics across Michigan. Of 8468 patients, 53.3% had AF, 45.6% had VTE, and 1.1% had both. Of these, 696 (8.2%) switched from warfarin to a DOAC. There were no significant differences between switchers and nonswitchers for percentage of time with a therapeutic international normalized ratio on warfarin, urban-rural residence status, or health insurance. Switchers were more often white (83.3% vs 77.7%; P < .001), partnered (67.3% vs 59.2%; P < .001), or resided in a zip code with a higher median household income (P < .001). The results show that sociodemographic factors, such as race, partnered status, and income are associated with a patient's likelihood of switching to a DOAC vs remaining on warfarin therapy. Although clinical factors predominate, the reason for, and impact of, these observed variations in care requires further investigation.
Disciplines
Publication Date
December 12, 2017
DOI
10.1182/BLOODADVANCES.2017012377
Citation Information
Schaefer JK, Sood SL, Haymart B, Gu X, Kong X, Kline-Rogers E, Almany S, Kozlowski J, Krol GD, Kaatz S, Froehlich JB, Barnes GD. Sociodemographic factors in patients continuing warfarin vs those transitioning to direct oral anticoagulants. Blood Adv. 2017 Dec 7;1(26):2536-2540. doi: 10.1182/bloodadvances.2017012377. PMID: 29296905; PMCID: PMC5728645.