Trends in the Longitudinal Utilization of Oral Anticoagulants Among Newly Diagnosed Atrial Fibrillation Patients With Commercial, Medicare, and Medicaid Insurance.

Long-term oral anticoagulation (OAC) is recommended for stroke prevention for most patients with atrial fibrillation (AF) and elevated stroke risk. 1 January CT Wann LS Calkins H Chen LY Cigarroa JE Cleveland JC Ellinor PT Ezekowitz MD Field ME Furie KL Heidenreich PA Murray KT Shea JB Tracy CM Yancy CW 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019; 74: 104-132 Crossref PubMed Scopus (1174) Google Scholar While trends in initiation of OAC have been described, 2 Essien UR Kim N Hausmann LRM Mor MK Good CB Magnani JW Litam TMA Gellad WF Fine MJ Disparities in anticoagulant therapy initiation for incident atrial fibrillation by race/ethnicity among patients in the veterans health administration system. JAMA Netw Open. 2021; 4e2114234 Crossref Scopus (32) Google Scholar ,3 Vora P Morgan Stewart H Russell B Asiimwe A Brobert G Time trends and treatment pathways in prescribing individual oral anticoagulants in patients with nonvalvular atrial fibrillation: an observational study of more than three million patients from Europe and the United States. Int J Clin Pract. 2022; 20226707985 Crossref Scopus (7) Google Scholar long-term trends in utilization of OAC in patients continuously followed for AF have not been adequately explored. Some healthcare systems adapted anticoagulation services to respond to disruptions during the COVID-19 pandemic. 4 Mohammad I Berlie HD Lipari M Martirosov AL Duong AA Faraj M Bacon O Garwood CL Ambulatory care practice in the COVID-19 era: redesigning clinical services and experiential learning. J Am Coll Clin Pharm. 2020; 3: 1129-1137 Crossref PubMed Scopus (15) Google Scholar We thus investigated how OACs were utilized in patients with newly diagnosed AF from 2018 to 2021 across 3 insurance types: Medicare, Medicaid, and commercial.