This Study Observes the Use of New Oral Anticoagulants (NOACs) in Patients With a Heart Rhythm Disorder in Spain
- Conditions
- Atrial Fibrillation
- Interventions
- Drug: NOAC
- Registration Number
- NCT03285373
- Lead Sponsor
- Boehringer Ingelheim
- Brief Summary
The primary objective of the study is to describe the usage of NOACs in patients with NVAF, in the hospital setting, based on the baseline characteristics at the time of first NOAC initiation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1008
- The patient is willing and provides written informed consent to participate in this study
- The patient is at least 18 years of age
- The patient has a diagnosis of non-valvular atrial fibrillation (NVAF)
- The patient is on treatment with NOAC according to its approved local SmPC and has initiated his first NOAC starting from November 2016
-if the current participating patient participate in any clinical trial of a drug or device will be excluded
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description patients with NVAF NOAC patients with Non Valvular Atrial Fibrillation
- Primary Outcome Measures
Name Time Method Usage of NOAC Based on Baseline Characteristics: Age at the Time of the First NOAC Initiation Start of the first NOAC treatment Usage of NOAC in patients diagnosed with NVAF, in the hospital setting, based on the baseline characteristics; age, at the time of the start of the first NOAC initiation.
Usage of NOAC Based on Baseline Characteristics: CHA2DS2-VASc Scores at the Time of the First NOAC Initiation Start of the first NOAC treatment Usage of NOAC in patients diagnosed with NVAF, in the hospital setting, based on the baseline characteristics: Congestive heart failure, Hypertension, Age (\> 75), Diabetes mellitus, Stroke/TIA, Vascular disease, Age 65-74, Sex Category (CHA2DS2-VASc Score) at the time of the start of the first NOAC initiation.
The CHA2DS2-VASc score is a clinical prediction rule to estimate the risk of stroke in patients with Atrial Fibrillation (AF); it is frequently used to determine the need for an anticoagulation therapy, relating the high scores to a great risk of stroke and a low score corresponds to a lower risk of stroke. CHA2DS2-VASc stroke risk score may range from 0 to 9 with 0 being the best outcome.Number of Patients on Risk Based on CHA2DS2-VASc Scores at the Time of the First NOAC Initiation Start of the first NOAC treatment Number of patients on risk (Low, Moderate and High) based on CHA2DS2-VASc Scores at the time of the start of the first NOAC initiation.
The total CHA2DS2-VASc Scores score was stratified by category according to the following classification:
1. Low risk (score 0 in male; score 1 in female)
2. Moderate risk (score 1 in male; score 2 in female)
3. High risk (score ≥2 in male; score ≥3 in female)Usage of NOAC Based on Baseline Characteristics: HAS-BLED Score at the Time of the First NOAC Initiation Start of the first NOAC treatment Usage of NOAC in patients diagnosed with NVAF, in the hospital setting, based on the baseline characteristics: Hypertension, Abnormal renal and liver function, Stroke (1 point), Bleeding history or predisposition, Labile INR, Elderly (\>65 years), Drugs and Alcohol (HAS-BLED Score) at the time of the start of the first NOAC initiation. HAS-BLED bleeding risk score may range from 0 to 9 with 0 being the best outcome. The high scores to a great risk of bleeding and a low score corresponds to a lower risk of bleeding.
Number of Patients on Risk Based on HAS-BLED Score at the Time of the First NOAC Initiation Start of the first NOAC treatment Number of patients on risk (Low, Moderate and High) based on HAS-BLED Score at the time of the start of the first NOAC initiation.
The total HAS-BLED Score was stratified by category according to the following classification:
1. Low risk (score 0)
2. Moderate risk (score 1-2)
3. High risk (score ≥3)
- Secondary Outcome Measures
Name Time Method Appropriateness of NOACs Prescription single visit (Day 1) Appropriateness of NOACs prescription based on national recommendations. For this, it was reviewed if the presence of at least one of the following clinical reason or reason related to International Normalized Ratio (INR) control were met.
Reason 1: Patients with known hypersensitivity or with specific contraindications to the use of acenocoumarol or warfarin; Reason 2: Patients with a history of intracranial hemorrhage (ICH) (except during the acute phase); Reason 3: Patients with ischemic stroke who present high-risk clinical and neuroimaging criteria for ICH; Reason 4: Patients on VKA treatment who suffer from severe arterial thromboembolic events despite good INR control; Reason 5: Patients who have started treatment with VKA in which it is not possible to maintain INR control within range (2-3) despite good therapeutic compliance; Reason 6: impossibility of access to conventional INR control; Reason 7: Other reason; Reason 8; Unknown.Mean Number of Visits to the Physician Per Year 1 year (data collected during single visit on day 1) Mean number of visits to the physician per year considered for the NOAC Management.
Duration of First NOAC, All NOAC and Subsequent NOAC Treatment Through the observational period with an average of 9.4 (first NOAC), 9.6 (All NOAC) and 5.1 (Subsequent NOAC) months, data collected during a single visit. Duration of NOAC treatment (First NOAC, All NOAC and Subsequent NOAC).
Number of Patients Who Changed From One NOAC to a New NOAC Type and Dose single visit (Day 1) Number of patients who changed from one NOAC to a new NOAC type and dose. The treatment and its dose displayed below refer to the subsequent NOAC.
Reason for Treatment Changes Start of the first NOAC treatment Reason for treatment changes such as discontinuing the NOAC treatment, to adjust the NOAC dose or to change to a new NOAC.
Number of Patients With Previous Treatment With Vitamin K Antagonists single visit (Day 1) Number of patient with Previous Treatment with Vitamin K Antagonists.
Number of Patients Who Required Discontinuing the NOAC Treatment, to Adjust the NOAC Dose or to Change to a New NOAC single visit (Day 1) Number of patients who required discontinuing the NOAC treatment, to adjust the NOAC dose or to change to a new NOAC
Duration of Previous VKA Treatment Through the observational period with an average of 43.8 months, data collected during a single visit. Duration of previous VKA treatment is the time from start of the VKA treatment until stopped to start with the first NOAC
Patient's Knowledge About His Condition single visit (Day 1) At the time of the inclusion, the physician performed a following small questionnaire to the patients, to answer yes/no, in order to assess the patient's knowledge about his illness and the anticoagulant treatment prescribed.
Question 1. Do you know why you are being treated with an anticoagulant? Question 2. Do you know which the effect of the anticoagulant treatment is? Question 3. Do you know what could happen if you don't take the anticoagulant treatment? Question 4. Do you mind taking the anticoagulant treatment?
Trial Locations
- Locations (67)
Hospital Dr. José Molina Orosa
🇪🇸Arrecife, Las Palmas, Spain
Hospital Infanta Cristina
🇪🇸Badajoz, Spain
Hospital Universitario de Bellvitge
🇪🇸Hospitalet De Ll (Barcelona), Spain
Hospital Quirónsalud Sur
🇪🇸Alcorcón (Madrid), Spain
Hospital del Mar
🇪🇸Barcelona, Spain
Centro Médico Puerto
🇪🇸El Puerto De Santa Maria (Cádiz), Spain
Hospital Galdakao
🇪🇸Galdakao (Vizcaya), Spain
H. Residencia Sant Camil
🇪🇸Barcelona, Spain
H de Cabueñes
🇪🇸Asturias, Spain
H. del Mar
🇪🇸Barcelona, Spain
H. Moisés Broggi
🇪🇸Barcelona, Spain
Complejo Hospitalario Arquitecto Marcide
🇪🇸Ferrol (A Coruña), Spain
Hospital Gregorio Marañon
🇪🇸Madrid, Spain
Hospital Universitario Central de Asturias
🇪🇸Oviedo (Asturias), Spain
Hospital Fundación Jiménez Díaz
🇪🇸Madrid, Spain
H. Quirón Salud H. Sur Alcorcón
🇪🇸Madrid, Spain
Hospital de Mérida
🇪🇸Mérida, Spain
Centro de Especialidades Dr. San Martin
🇪🇸Pamplona, Spain
Hospital de Manises
🇪🇸Manises (Valencia), Spain
Hospital Ochoa
🇪🇸Marbella (Málaga), Spain
Hospital Quirón Campo de Gibraltar
🇪🇸Palmones (Cádiz), Spain
Complejo Hospitalario de Pontevedra
🇪🇸Pontevedra, Spain
Clínica Santa Elena
🇪🇸Torremolinos (Málaga), Spain
H. Miguel Servet
🇪🇸Zaragoza, Spain
Hospital García Orcoyen
🇪🇸Estella (Navarra), Spain
H. Universitario Dr. Negrín
🇪🇸Las Palmas, Spain
Hospital de la Princesa
🇪🇸Madrid, Spain
Hospital General San Agustin
🇪🇸Linares (Jaen), Spain
Medical Practice
🇪🇸Sevilla, Spain
Hospital Universitario Lucus Augusti
🇪🇸Lugo, Spain
H Aranda Duero
🇪🇸Burgos, Spain
Hospital de Cáceres
🇪🇸Cáceres, Spain
Clínica Del Río Estepona y San Pedro
🇪🇸Estepona (Málaga), Spain
Hospital Vithas La Salud
🇪🇸Granada, Spain
H. U. Guadalajara
🇪🇸Guadalajara, Spain
H. C. U. Salamanca
🇪🇸Salamanca, Spain
Hospital Universitario Puerta del Hierro
🇪🇸Majadahonda (Madrid), Spain
Hospital de Mataró
🇪🇸Mataró (Barcelona), Spain
Hospital Universatio de Albacete
🇪🇸Albacete, Spain
Clínica Modelo
🇪🇸A Coruña, Spain
Hospital General Universitario de Alicante
🇪🇸Alicante, Spain
Clínica Sagrada Familia
🇪🇸Barcelona, Spain
Hospital Basurto
🇪🇸Bilbao, Spain
Hospital General de Elche
🇪🇸Elche (Alicante), Spain
Hospital Vinalopo Salud
🇪🇸Elche (Alicante), Spain
Hospital Juan Ramon Jiménez
🇪🇸Huelva, Spain
Hospital Nuestra Señora del Rosario
🇪🇸Madrid, Spain
Hospital de Son Llatzer
🇪🇸Palma De Mallorca (Baleares), Spain
Policlínic Sant Cugat
🇪🇸Sant Cugat Del Valles (Barcelona), Spain
HM Hospitales Madrid
🇪🇸Torrelodones (Madrid), Spain
Hospital Universitari Parc Taulí
🇪🇸Sabadell (Barcelona), Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital Clínico Universitario de Santiago de Compostela
🇪🇸Santiago De Compostela (A Coruña), Spain
CH Santiago de Compostela
🇪🇸Santiago De Compostela (A Coruña), Spain
Complejo Hospitalario Universitario de Santiago
🇪🇸Santiago De Compostela (A Coruña), Spain
Hospital Santa Santa Bárbara
🇪🇸Soria, Spain
Complejo H. Universitario de Canarias
🇪🇸Tenerife, Spain
Hospital Nuestra Señora de la Candelaria
🇪🇸Tenerife, Spain
Hospital Universitari de Tarragona Joan XXIII
🇪🇸Tarragona, Spain
Hospital Duque del Infantado
🇪🇸Sevilla, Spain
H. Clínico Universitario
🇪🇸Zaragoza, Spain
Complejo Asistencial de Zamora
🇪🇸Zamora, Spain
Pius Hospital de Valls
🇪🇸Valls (Tarragona), Spain
Hospital Universitari de La Plana
🇪🇸Vila-Real (Castellón), Spain
Hospital Lluis Alcanyis
🇪🇸Xàtiva (Valencia), Spain
H. Royo Villanova
🇪🇸Zaragoza, Spain
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain