{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T02:47:55Z","timestamp":1767408475775,"version":"3.37.3"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T00:00:00Z","timestamp":1515628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non\u2010VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using claims data (2010\u20132014), we studied a cohort of new nursing home residents aged \u226565 years receiving OAC. Further, OAC use in patients with atrial fibrillation (AF) was examined over the years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 16\u2009804 patients (median age: 85 years, 75% female, 44% with renal disease) were included. The majority received phenprocoumon as first OAC (58.0%), followed by rivaroxaban (28.1%). Over the study period, NOAC use increased substantially. Initiating NOAC instead of VKA was predicted by a previous stroke (adjusted odds ratio: 1.76; 95% confidence interval: 1.49\u20132.08). In contrast, renal disease predicted VKA initiation (0.66; 0.59\u20130.75) as did the presence of a prosthetic heart valve. Switching from VKA to NOAC was predicted by a stroke (2.55; 2.00\u20133.24), bleeding events and a recent hospitalization. During 2010\u20132014, the proportion of AF patients with a CHADS2 score \u22652 receiving OAC increased from 27% to 46%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NOACs are increasingly used in German nursing homes, both for initial anticoagulation but also in VKA pre\u2010treated patients. Switching from VKA to NOAC was substantially influenced by aspects such as intended higher effectiveness and safety but probably also practicability due to less blood monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.13474","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T10:02:37Z","timestamp":1510912957000},"page":"590-601","source":"Crossref","is-referenced-by-count":10,"title":["Use of oral anticoagulants in German nursing home residents: drug use patterns and predictors for treatment choice"],"prefix":"10.1111","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3957-9721","authenticated-orcid":false,"given":"Kathrin","family":"Jobski","sequence":"first","affiliation":[{"name":"Department of Health Services Research Carl von Ossietzky University Oldenburg  Oldenburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falk","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Carl von Ossietzky University Oldenburg  Oldenburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Herget\u2010Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Medicine Rotes Kreuz Hospital  Bremen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"D\u00f6rks","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Carl von Ossietzky University Oldenburg  Oldenburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,11]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Arzneimittelkommission der Deutschen \u00c4rzteschaft (AKd\u00c4).Leitfaden: Orale Antikoagulation bei nicht valvul\u00e4rem Vorhofflimmern(2nd Edition) [online].2016. 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Leitlinien f\u00fcr das Management von Vorhofflimmern[online].2013. Available athttps:\/\/leitlinien.dgk.org\/files\/Pocket_Leitlinien_Vorhofflimmern_Update2013.pdf(last accessed 11 December 2017)."},{"key":"e_1_2_9_22_1","unstructured":"Arbeitsgemeinschaft der Wissenschaftlichen Fachgesellschaften.S3\u2010Leitlinie Sekund\u00e4rprophylaxe isch\u00e4mischer Schlaganfall und transitorische isch\u00e4mische Attacke [online].2015. Available athttp:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/030-133k_S3_Sekun%C3%A4rprophylaxe_isch%C3%A4mischer_Schlaganfall_2015-02.pdf(last accessed 31 March 2017)."},{"key":"e_1_2_9_23_1","unstructured":"Arzneimittelkommission der deutschen \u00c4rzteschaft (AKd\u00c4).Leitfaden: Orale Antikoagulation bei nicht valvul\u00e4rem Vorhofflimmern [online].2012. 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