Oral anticoagulant prescribing trends in T2DM in the UK

  • Alwafi H & al.
  • BMJ Open
  • 15 May 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • The prescribing prevalence of oral anticoagulants (OACs) in patients with type 2 diabetes mellitus (T2DM) has increased markedly between 2001 and 2015.
  • The increase was not consistent across different gender and age groups.
  • There has been a clear shift in prescribing towards direct OACs (DOACs) compared with warfarin since their introduction to the UK market.

Why this matters      

  • This is the first study that evaluated the overall and stratified trend of OAC medication prescribing in patients with T2DM over a 15-year period.
  • Findings warrant future studies to assess the safety of coadministration of OAC medications and antidiabetic therapy.

Study design

  • This retrospective drug utilisation study used data from The Health Improvement Network (THIN) database, UK to evaluate the prescribing trends of OACs in 361,635 patients with T2DM from 2001-2015.
  • Funding: None disclosed.

Key results

  • 36,570 patients with T2DM were prescribed OACs from 2001 to 2015.
  • The prescribing prevalence of OACs increased by 50%, from 4.4 (95% CI, 4.2-4.6) per 100 persons in 2001 to 6.6 (95% CI, 6.5-6.7) per 100 persons in 2015.
    • in men: overall increase of 54.3%.
    • in women: overall increase of 47.5%.
    • aged ≥75 years: increased from 7.1 to 11.6 per 100 persons.
    • aged 65-74 years: increased from 5.7 to 6.5 per 100 persons.
    • aged
  • Warfarin was the most common OAC prescribed during the entire study period (86.3%) and its use declined by 14%, from 98.9 (95% CI, 98.4-99.4) per 100 persons in 2001 to 85.1 (95% CI, 84.6-85.7) per 100 persons in 2015.
  • In contrast, there was a corresponding increase in the prescribing prevalence of DOACs from 0.1 (95% CI, 0.08-0.23) per 100 persons in 2010 to 17.6 (95% CI, 17.1-18.2) per 100 persons in 2015.

Limitations

  • Possibility of underestimation of OAC prescription.