{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:14:28Z","timestamp":1767665668398},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"published-print":{"date-parts":[[2023,3]]},"abstract":"Zusammenfassung<\/jats:title>\n Ziel der Studie Seit 2011 erweitern die nicht-Vitamin-K-abh\u00e4ngigen\n oralen Antikoa-gulanzien (NOAK) das Spektrum der Antikoagulation.\n Zun\u00e4chst war die Zulassung der NOAK auf die Prophylaxe von\n postoperativen Thrombosen beschr\u00e4nkt, im Verlauf wurde das Spektrum auf\n die Therapie von Thrombosen und Embolien sowie zur Antikoagulation bei\n nicht-valvul\u00e4rem Vorhofflimmern erweitert. In dieser Studie sollte\n untersucht werden, wie sich die Zulassung der NOAK auf das Verordnungsverhalten\n der Haus\u00e4rzte in den ersten Jahren der Zulassung ausgewirkt hat.<\/jats:p>\n Methodik In einer retrospektiven L\u00e4ngsschnittuntersuchung wurden\n die Verordnungen von Antikoagulanzien zwischen 2012 und 2017 in 3 Hausarztpraxen\n im Raum Bonn analysiert. Dabei wurden alle Patienten in die Studie\n eingeschlossen, bei denen mindestens eine Verordnung eines NOAK oder eines\n Vitamin-K-Antagonisten (VKA) in diesem Untersuchungszeitraum im\n Verwaltungssystem der Praxen dokumentiert war.<\/jats:p>\n Ergebnisse Insgesamt wurden Akten von n=579 Patienten ausgewertet\n (47% weib-lich; Alter im Mittel 75 Jahre). Davon nahmen 47% ein\n VKA und 40% ein NOAK (59% Rivaroxaban, 29% Apixaban,\n 9% Dabigatran und 3% Edoxaban) ein. Im Unter-suchungszeitraum\n nahm der Anteil von VKA-Verordnungen von 45% auf 14% ab und der\n Anteil der NOAK von 28% auf 87% zu. Bei 12% der\n Patienten kam es zu einem Wechsel der Antikoagulation. Dabei war der Wechsel von\n einem VKA auf ein NOAK (70%) am h\u00e4ufigsten.<\/jats:p>\n Schlussfolgerung Nach der Marktzulassung nahm der Anteil an NOAK bei den\n Erstverordnungen kontinuierlich zu. Dieser Trend ist auch in anderen\n europ\u00e4ischen Studien erkennbar. Die VKA werden vor allem Patienten mit\n einer stabilen oralen Antikoagulation verordnet. Ein Wechsel der Antikoagulation\n wird, wie in den Leitlinien empfohlen, vor allem bei Problemen unter der\n Therapie durchgef\u00fchrt. Sollte der Trend bei der Verordnung von\n Antikoagulantien anhalten, werden mittelfristig VKA nur bei langj\u00e4hrig\n stabil eingestellten Patienten und bei Patienten mit k\u00fcnstlichen\n Herzklappen verordnet werden.<\/jats:p>","DOI":"10.1055\/a-1778-3831","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:51:07Z","timestamp":1649983867000},"page":"193-198","source":"Crossref","is-referenced-by-count":3,"title":["\u00c4nderungen bei der Verordnung oraler Antikoagulation in\n Hausarztpraxen nach Einf\u00fchrung der direkten oralen\n Antikoagulanzien"],"prefix":"10.1055","volume":"85","author":[{"given":"Markus","family":"Bleckwenn","sequence":"additional","affiliation":[{"name":"Selbstst\u00e4ndige Abteilung f\u00fcr Allgemeinmedizin,\n Medizinische Fakult\u00e4t, Universit\u00e4t Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine","family":"Schumacher","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Allgemeinmedizin und Interprofessionelle\n Versorgung, Universit\u00e4t Witten\/Herdecke Department f\u00fcr\n Humanmedizin, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Therese","family":"Puth","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Medizinische Biometrie, Informatik und\n Epidemiologie (IMBIE), Universit\u00e4tsklinikum Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes Maximilian","family":"Just","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Allgemeinmedizin und Interprofessionelle\n Versorgung, Universit\u00e4t Witten\/Herdecke Department f\u00fcr\n Humanmedizin, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Weckbecker","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Allgemeinmedizin und Interprofessionelle\n Versorgung, Universit\u00e4t Witten\/Herdecke Department f\u00fcr\n Humanmedizin, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"S J Connolly","year":"2009","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1056\/NEJMoa1310907","article-title":"Edoxaban versus warfarin in patients with atrial fibrillation","volume":"369","author":"R P Giugliano","year":"2013","journal-title":"N Engl J 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