New study finds racial disparities in oral anticoagulant use

Black patients with atrial fibrillation are significantly less likely to receive oral anticoagulants—particularly newer, more effective versions—than white and Hispanic patients, according to a new study published today in JAMA Cardiology.

First author Utibe R. Essien, M.D., M.P.H., assistant professor in the University of Pittsburgh Division of General Internal Medicine, used the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry (ORBIT-AF II) to source for the study. He conducted the research during his fellowship at Massachusetts General Hospital.

Registry data for 11,100 , 646 black patients and 671 Hispanic patients with atrial fibrillation collected from February 2013 through June 2016 was included in the analysis. After controlling for clinical and sociodemographic factors, black patients had 25 percent lower odds of receiving any oral anticoagulant drugs compared to their white and Hispanic counterparts, and 37 percent lower odds of receiving the easier to use and likely safer direct-acting oral anticoagulants. There was no difference in prescriptions between whites and Hispanics.

"For patients with atrial fibrillation, long-term oral anticoagulant use can reduce their risk of stroke. Even after our analysis adjusted for socioeconomic factors, were still less likely to receive these types of drugs," said Essien. "Blacks with atrial fibrillation are already at a higher risk of complications, so improving health literacy and reducing disparities related to medication use could help improve their overall quality of care and reduce complications."

Many factors, including limited access to specialists, out-of-pocket costs, medication adherence and implicit bias, have been suggested as possible reasons for the disparities in care for patients with , but further research is needed to address and correct these issues.


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More information: Utibe R. Essien et al, Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation, JAMA Cardiology (2018). DOI: 10.1001/jamacardio.2018.3945
Journal information: JAMA Cardiology

Citation: New study finds racial disparities in oral anticoagulant use (2018, November 28) retrieved 12 December 2019 from https://medicalxpress.com/news/2018-11-racial-disparities-oral-anticoagulant.html
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