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American Journal of Medicine

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Warfarin Use in Primary Care in the UK - Initiation of VKA

Although warfarin is obviously a highly effective therapy, it is difficult to use. Both patients and doctors are often frightened of the potential adverse effects of bleeding caused by the anticoagulant. Figure 6 shows data from a UK database for use of warfarin in general medical practice.[9] The patients with atrial fibrillation who should be anticoagulated are divided by age, and it can be seen that as age increases, it is increasingly less likely that the patient will be anticoagulated, whereas we know that as age advances, the risk of thromboembolism becomes greater.

Data from the same database on the right of the Figure show that after 2 years, even the percentage of patients who had started on warfarin had dropped to 60%, and by 3 years only half the patients were still taking the anticoagulant. Camm J. Am J Med 2013; published on-line at http://education.amjmed.com/00000.

References

[9] Gallagher AM, Rietbrock S, Plumb J, van Staa TP. Initiation and persistence of warfarin or aspirin in patients with chronic atrial fibrillation in general practice: do the appropriate patients receive stroke prophylaxis? J Thromb Haemost. 2008;6:1500-1506.