Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database
Background:Direct oral anticoagulants (DOACs) are effective in reducing thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). However, little is known about trends in NVAF prevalence and DOAC prescriptions in daily clinical practice. This study investigated the current sta...
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| Veröffentlicht in: | Circulation Journal 2020/04/24, Vol.84(5), pp.706-713 |
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| creator | Narita, Noritomo Okumura, Ken Kinjo, Takahiko Mikami, Joko Tsushima, Katsuko Takahashi, Reiko Noro, Makiko Hashimoto, Ayaka Sasaki, Teiko Takaki, Misaki Ishidoya, Emiko Narita, Yurika Imai, Hideno Ono, Emiko Tomita, Hirofumi |
| description | Background:Direct oral anticoagulants (DOACs) are effective in reducing thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). However, little is known about trends in NVAF prevalence and DOAC prescriptions in daily clinical practice. This study investigated the current status and trends in NVAF prevalence and DOAC prescriptions in a region of Japan.Methods and Results:Annual data for the 4 years from May 2014 to May 2017 in the Tsugaru region of Aomori Prefecture, Japan, were obtained for analysis from the Japanese National Health Insurance database (“Kokuho” database [KDB]). The prevalence of NVAF in subjects aged 40–74 years increased gradually over the 4-year study period (1,094/57,452 [1.90%] in 2014, 1,055/56,018 [1.88%] in 2015, 1,072/54,256 [1.98%] in 2016, and 1,154/52,341 [2.20%] in 2017). The proportion of NVAF patients prescribed warfarin decreased (42%, 33%, 24%, and 21% in 2014, 2015, 2016, and 2017, respectively), the proportion of those prescribed DOACs increased (30%, 42%, 50%, and 57%, respectively), and the proportion not prescribed an oral anticoagulant (OAC) decreased (28%, 25%, 26%, and 22%, respectively). However, 17% of patients with a CHADS2score ≥2 were not prescribed an OAC in 2017.Conclusions:By using the KDB we found that the prevalence of NVAF has increased gradually from 2014 to 2017. In the Tsugaru region in Japan, DOACs prescriptions increased and warfarin prescriptions decreased over the 4-year period. |
| doi_str_mv | 10.1253/circj.CJ-18-0989 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2384212127</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2384212127</sourcerecordid><originalsourceid>FETCH-LOGICAL-c622t-ddd376b5889db2304ac1a19875f0cd189b830de54754bdd1299a44a0196b06063</originalsourceid><addsrcrecordid>eNpFkd1u0zAYhiMEYmNwzhHyIScZ_ktiH1ZlZaumMU0dp9aX-GvrynWKnUzqWW-CS-DG4EZIf9gUybHs531k-82yj4xeMl6IL42LzepyPM2ZyqlW-lV2zoSscqk4fX2Yl7lWUpxl71JaUco1LfTb7ExwzkTF5Xn2exYx2ERcIPcRn8BjaJC0c3LXhvwH-KfeQySjLjrwZOLq6LyHzrWBQLBkFDrXtLDoT2uzJUbYbPc2IFPYQMCE5AEXw-bf3e7P7tcQAb9NLpHH5MKCdEskd4fw4L9G8N2S3ITUR9if4yt0UEPC99mbOfiEH07_i-xxcjUbX-e337_djEe3eVNy3uXWWlGVdaGUtjUXVELDgGlVFXPaWKZ0rQS1WMiqkLW1jGsNUgJluqxpSUtxkX0-ejex_dlj6szapQaHKwds-2S4UJKz4asGlB7RJrYpRZybTXRriFvDqNmXYw7lmPHUMGX25QyRTyd7X6_RPgf-tzEAkyOwSh0s8BmAODyzx5NRSVPshxfzC7CEaDCIf_5aqNo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2384212127</pqid></control><display><type>article</type><title>Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese</source><creator>Narita, Noritomo ; Okumura, Ken ; Kinjo, Takahiko ; Mikami, Joko ; Tsushima, Katsuko ; Takahashi, Reiko ; Noro, Makiko ; Hashimoto, Ayaka ; Sasaki, Teiko ; Takaki, Misaki ; Ishidoya, Emiko ; Narita, Yurika ; Imai, Hideno ; Ono, Emiko ; Tomita, Hirofumi</creator><creatorcontrib>Narita, Noritomo ; Okumura, Ken ; Kinjo, Takahiko ; Mikami, Joko ; Tsushima, Katsuko ; Takahashi, Reiko ; Noro, Makiko ; Hashimoto, Ayaka ; Sasaki, Teiko ; Takaki, Misaki ; Ishidoya, Emiko ; Narita, Yurika ; Imai, Hideno ; Ono, Emiko ; Tomita, Hirofumi</creatorcontrib><description>Background:Direct oral anticoagulants (DOACs) are effective in reducing thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). However, little is known about trends in NVAF prevalence and DOAC prescriptions in daily clinical practice. This study investigated the current status and trends in NVAF prevalence and DOAC prescriptions in a region of Japan.Methods and Results:Annual data for the 4 years from May 2014 to May 2017 in the Tsugaru region of Aomori Prefecture, Japan, were obtained for analysis from the Japanese National Health Insurance database (“Kokuho” database [KDB]). The prevalence of NVAF in subjects aged 40–74 years increased gradually over the 4-year study period (1,094/57,452 [1.90%] in 2014, 1,055/56,018 [1.88%] in 2015, 1,072/54,256 [1.98%] in 2016, and 1,154/52,341 [2.20%] in 2017). The proportion of NVAF patients prescribed warfarin decreased (42%, 33%, 24%, and 21% in 2014, 2015, 2016, and 2017, respectively), the proportion of those prescribed DOACs increased (30%, 42%, 50%, and 57%, respectively), and the proportion not prescribed an oral anticoagulant (OAC) decreased (28%, 25%, 26%, and 22%, respectively). However, 17% of patients with a CHADS2score ≥2 were not prescribed an OAC in 2017.Conclusions:By using the KDB we found that the prevalence of NVAF has increased gradually from 2014 to 2017. In the Tsugaru region in Japan, DOACs prescriptions increased and warfarin prescriptions decreased over the 4-year period.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-18-0989</identifier><identifier>PMID: 32213724</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Administration, Oral ; Adult ; Aged ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - epidemiology ; Cross-Sectional Studies ; Databases, Factual ; Direct oral anticoagulant ; Drug Prescriptions ; Drug Utilization Review - trends ; Factor Xa Inhibitors - administration & dosage ; Factor Xa Inhibitors - adverse effects ; Female ; Humans ; Japan - epidemiology ; Kokuho database ; Male ; Middle Aged ; National Health Programs ; Practice Patterns, Physicians' - trends ; Prevalence ; Retrospective Studies ; Risk Factors ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - prevention & control ; Time Factors ; Treatment Outcome ; Warfarin ; Warfarin - administration & dosage ; Warfarin - adverse effects</subject><ispartof>Circulation Journal, 2020/04/24, Vol.84(5), pp.706-713</ispartof><rights>2020 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c622t-ddd376b5889db2304ac1a19875f0cd189b830de54754bdd1299a44a0196b06063</citedby><cites>FETCH-LOGICAL-c622t-ddd376b5889db2304ac1a19875f0cd189b830de54754bdd1299a44a0196b06063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32213724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Narita, Noritomo</creatorcontrib><creatorcontrib>Okumura, Ken</creatorcontrib><creatorcontrib>Kinjo, Takahiko</creatorcontrib><creatorcontrib>Mikami, Joko</creatorcontrib><creatorcontrib>Tsushima, Katsuko</creatorcontrib><creatorcontrib>Takahashi, Reiko</creatorcontrib><creatorcontrib>Noro, Makiko</creatorcontrib><creatorcontrib>Hashimoto, Ayaka</creatorcontrib><creatorcontrib>Sasaki, Teiko</creatorcontrib><creatorcontrib>Takaki, Misaki</creatorcontrib><creatorcontrib>Ishidoya, Emiko</creatorcontrib><creatorcontrib>Narita, Yurika</creatorcontrib><creatorcontrib>Imai, Hideno</creatorcontrib><creatorcontrib>Ono, Emiko</creatorcontrib><creatorcontrib>Tomita, Hirofumi</creatorcontrib><title>Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Direct oral anticoagulants (DOACs) are effective in reducing thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). However, little is known about trends in NVAF prevalence and DOAC prescriptions in daily clinical practice. This study investigated the current status and trends in NVAF prevalence and DOAC prescriptions in a region of Japan.Methods and Results:Annual data for the 4 years from May 2014 to May 2017 in the Tsugaru region of Aomori Prefecture, Japan, were obtained for analysis from the Japanese National Health Insurance database (“Kokuho” database [KDB]). The prevalence of NVAF in subjects aged 40–74 years increased gradually over the 4-year study period (1,094/57,452 [1.90%] in 2014, 1,055/56,018 [1.88%] in 2015, 1,072/54,256 [1.98%] in 2016, and 1,154/52,341 [2.20%] in 2017). The proportion of NVAF patients prescribed warfarin decreased (42%, 33%, 24%, and 21% in 2014, 2015, 2016, and 2017, respectively), the proportion of those prescribed DOACs increased (30%, 42%, 50%, and 57%, respectively), and the proportion not prescribed an oral anticoagulant (OAC) decreased (28%, 25%, 26%, and 22%, respectively). However, 17% of patients with a CHADS2score ≥2 were not prescribed an OAC in 2017.Conclusions:By using the KDB we found that the prevalence of NVAF has increased gradually from 2014 to 2017. In the Tsugaru region in Japan, DOACs prescriptions increased and warfarin prescriptions decreased over the 4-year period.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Databases, Factual</subject><subject>Direct oral anticoagulant</subject><subject>Drug Prescriptions</subject><subject>Drug Utilization Review - trends</subject><subject>Factor Xa Inhibitors - administration & dosage</subject><subject>Factor Xa Inhibitors - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Kokuho database</subject><subject>Male</subject><subject>Middle Aged</subject><subject>National Health Programs</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - prevention & control</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Warfarin</subject><subject>Warfarin - administration & dosage</subject><subject>Warfarin - adverse effects</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkd1u0zAYhiMEYmNwzhHyIScZ_ktiH1ZlZaumMU0dp9aX-GvrynWKnUzqWW-CS-DG4EZIf9gUybHs531k-82yj4xeMl6IL42LzepyPM2ZyqlW-lV2zoSscqk4fX2Yl7lWUpxl71JaUco1LfTb7ExwzkTF5Xn2exYx2ERcIPcRn8BjaJC0c3LXhvwH-KfeQySjLjrwZOLq6LyHzrWBQLBkFDrXtLDoT2uzJUbYbPc2IFPYQMCE5AEXw-bf3e7P7tcQAb9NLpHH5MKCdEskd4fw4L9G8N2S3ITUR9if4yt0UEPC99mbOfiEH07_i-xxcjUbX-e337_djEe3eVNy3uXWWlGVdaGUtjUXVELDgGlVFXPaWKZ0rQS1WMiqkLW1jGsNUgJluqxpSUtxkX0-ejex_dlj6szapQaHKwds-2S4UJKz4asGlB7RJrYpRZybTXRriFvDqNmXYw7lmPHUMGX25QyRTyd7X6_RPgf-tzEAkyOwSh0s8BmAODyzx5NRSVPshxfzC7CEaDCIf_5aqNo</recordid><startdate>20200424</startdate><enddate>20200424</enddate><creator>Narita, Noritomo</creator><creator>Okumura, Ken</creator><creator>Kinjo, Takahiko</creator><creator>Mikami, Joko</creator><creator>Tsushima, Katsuko</creator><creator>Takahashi, Reiko</creator><creator>Noro, Makiko</creator><creator>Hashimoto, Ayaka</creator><creator>Sasaki, Teiko</creator><creator>Takaki, Misaki</creator><creator>Ishidoya, Emiko</creator><creator>Narita, Yurika</creator><creator>Imai, Hideno</creator><creator>Ono, Emiko</creator><creator>Tomita, Hirofumi</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200424</creationdate><title>Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database</title><author>Narita, Noritomo ; Okumura, Ken ; Kinjo, Takahiko ; Mikami, Joko ; Tsushima, Katsuko ; Takahashi, Reiko ; Noro, Makiko ; Hashimoto, Ayaka ; Sasaki, Teiko ; Takaki, Misaki ; Ishidoya, Emiko ; Narita, Yurika ; Imai, Hideno ; Ono, Emiko ; Tomita, Hirofumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c622t-ddd376b5889db2304ac1a19875f0cd189b830de54754bdd1299a44a0196b06063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Databases, Factual</topic><topic>Direct oral anticoagulant</topic><topic>Drug Prescriptions</topic><topic>Drug Utilization Review - trends</topic><topic>Factor Xa Inhibitors - administration & dosage</topic><topic>Factor Xa Inhibitors - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Kokuho database</topic><topic>Male</topic><topic>Middle Aged</topic><topic>National Health Programs</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Stroke - prevention & control</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Warfarin</topic><topic>Warfarin - administration & dosage</topic><topic>Warfarin - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Narita, Noritomo</creatorcontrib><creatorcontrib>Okumura, Ken</creatorcontrib><creatorcontrib>Kinjo, Takahiko</creatorcontrib><creatorcontrib>Mikami, Joko</creatorcontrib><creatorcontrib>Tsushima, Katsuko</creatorcontrib><creatorcontrib>Takahashi, Reiko</creatorcontrib><creatorcontrib>Noro, Makiko</creatorcontrib><creatorcontrib>Hashimoto, Ayaka</creatorcontrib><creatorcontrib>Sasaki, Teiko</creatorcontrib><creatorcontrib>Takaki, Misaki</creatorcontrib><creatorcontrib>Ishidoya, Emiko</creatorcontrib><creatorcontrib>Narita, Yurika</creatorcontrib><creatorcontrib>Imai, Hideno</creatorcontrib><creatorcontrib>Ono, Emiko</creatorcontrib><creatorcontrib>Tomita, Hirofumi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Narita, Noritomo</au><au>Okumura, Ken</au><au>Kinjo, Takahiko</au><au>Mikami, Joko</au><au>Tsushima, Katsuko</au><au>Takahashi, Reiko</au><au>Noro, Makiko</au><au>Hashimoto, Ayaka</au><au>Sasaki, Teiko</au><au>Takaki, Misaki</au><au>Ishidoya, Emiko</au><au>Narita, Yurika</au><au>Imai, Hideno</au><au>Ono, Emiko</au><au>Tomita, Hirofumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2020-04-24</date><risdate>2020</risdate><volume>84</volume><issue>5</issue><spage>706</spage><epage>713</epage><pages>706-713</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:Direct oral anticoagulants (DOACs) are effective in reducing thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). However, little is known about trends in NVAF prevalence and DOAC prescriptions in daily clinical practice. This study investigated the current status and trends in NVAF prevalence and DOAC prescriptions in a region of Japan.Methods and Results:Annual data for the 4 years from May 2014 to May 2017 in the Tsugaru region of Aomori Prefecture, Japan, were obtained for analysis from the Japanese National Health Insurance database (“Kokuho” database [KDB]). The prevalence of NVAF in subjects aged 40–74 years increased gradually over the 4-year study period (1,094/57,452 [1.90%] in 2014, 1,055/56,018 [1.88%] in 2015, 1,072/54,256 [1.98%] in 2016, and 1,154/52,341 [2.20%] in 2017). The proportion of NVAF patients prescribed warfarin decreased (42%, 33%, 24%, and 21% in 2014, 2015, 2016, and 2017, respectively), the proportion of those prescribed DOACs increased (30%, 42%, 50%, and 57%, respectively), and the proportion not prescribed an oral anticoagulant (OAC) decreased (28%, 25%, 26%, and 22%, respectively). However, 17% of patients with a CHADS2score ≥2 were not prescribed an OAC in 2017.Conclusions:By using the KDB we found that the prevalence of NVAF has increased gradually from 2014 to 2017. In the Tsugaru region in Japan, DOACs prescriptions increased and warfarin prescriptions decreased over the 4-year period.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>32213724</pmid><doi>10.1253/circj.CJ-18-0989</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Oral Adult Aged Anticoagulants - administration & dosage Anticoagulants - adverse effects Atrial Fibrillation - diagnosis Atrial Fibrillation - drug therapy Atrial Fibrillation - epidemiology Cross-Sectional Studies Databases, Factual Direct oral anticoagulant Drug Prescriptions Drug Utilization Review - trends Factor Xa Inhibitors - administration & dosage Factor Xa Inhibitors - adverse effects Female Humans Japan - epidemiology Kokuho database Male Middle Aged National Health Programs Practice Patterns, Physicians' - trends Prevalence Retrospective Studies Risk Factors Stroke - diagnosis Stroke - epidemiology Stroke - prevention & control Time Factors Treatment Outcome Warfarin Warfarin - administration & dosage Warfarin - adverse effects |
| title | Trends in Prevalence of Non-Valvular Atrial Fibrillation and Anticoagulation Therapy in a Japanese Region ― Analysis Using the National Health Insurance Database |
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