TY - JOUR
T1 - Anticoagulation for nonvalvular atrial fibrillation
T2 - Effects of type of practice on physicians' self-reported behavior
AU - Bush, David E.
AU - Tayback, Matthew
N1 - Funding Information:
Supported in part by an unrestricted educational grant from DuPont Pharma, Wilmington, Delaware.
PY - 1998/2
Y1 - 1998/2
N2 - BACKGROUND: This study examines whether social and economic factors affect physician practice and attitude with regard to warfarin anticoagulation in patients with nonvalvular atrial fibrillation. METHODS: We identified physicians in Baltimore City, Baltimore County, and Prince George's County who (1) had written one or more prescriptions for a digitalis compound during the preceding year, and (2) were classified as general practitioners, family practice specialists, internists, or cardiologists. All 358 physicians fulfilling these criteria were surveyed by questionnaire. RESULTS: The overall response rate was 43%. Physicians who wrote 15% or more of their digitalis prescriptions for Medicaid patients said they used warfarin at significantly lower rates for patients with nonvalvular AF than other (66% versus 79%, P <0.01). The opposite pattern was seen with regard to aspirin. There were no significant differences in practice pattern between physicians located in urban vs. suburban counties. CONCLUSION: In our sample, self-reported anticoagulant practices for patients with nonvalvular AF were associated with the percentage of digitalis prescriptions written for Medicaid patients. In this metropolitan area, anticoagulant therapy was reportedly prescribed for approximately 75% of patients with nonvalvular atrial fibrillation.
AB - BACKGROUND: This study examines whether social and economic factors affect physician practice and attitude with regard to warfarin anticoagulation in patients with nonvalvular atrial fibrillation. METHODS: We identified physicians in Baltimore City, Baltimore County, and Prince George's County who (1) had written one or more prescriptions for a digitalis compound during the preceding year, and (2) were classified as general practitioners, family practice specialists, internists, or cardiologists. All 358 physicians fulfilling these criteria were surveyed by questionnaire. RESULTS: The overall response rate was 43%. Physicians who wrote 15% or more of their digitalis prescriptions for Medicaid patients said they used warfarin at significantly lower rates for patients with nonvalvular AF than other (66% versus 79%, P <0.01). The opposite pattern was seen with regard to aspirin. There were no significant differences in practice pattern between physicians located in urban vs. suburban counties. CONCLUSION: In our sample, self-reported anticoagulant practices for patients with nonvalvular AF were associated with the percentage of digitalis prescriptions written for Medicaid patients. In this metropolitan area, anticoagulant therapy was reportedly prescribed for approximately 75% of patients with nonvalvular atrial fibrillation.
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U2 - 10.1016/S0002-9343(97)00352-5
DO - 10.1016/S0002-9343(97)00352-5
M3 - Article
C2 - 9528733
AN - SCOPUS:0032006634
VL - 104
SP - 148
EP - 151
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 2
ER -