{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:58:42Z","timestamp":1765835922725,"version":"3.48.0"},"reference-count":29,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"FCT - Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/4255\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,4]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to assess the appropriateness of prescribing profiles and intake adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective longitudinal study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in the Regional Health Administration of Northern Portugal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The authors selected a database of 21\u2009854 patients with prescriptions for NOACs between January 2016 and December 2018 and were classified with AF until December 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The appropriate dosage of NOAC for patients with AF divided into three categories: contraindicated, inconsistent and consistent, based on the 2020 European Society of Cardiology guidelines for AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Dabigatran had a lower percentage of guideline-consistent doses (n=1657, 50.1%) than other drugs such as rivaroxaban (n=4737, 81.6%), apixaban (n=3830, 78.7%) and edoxaban (n=436, 82.1%). Most patients with an inconsistent dose were prescribed a lower dose than recommended based on their glomerular filtration rate (GFR). Among patients younger than 75 years with GFR &gt;60\u2009mL\/min, 59.8% (n=10\u2009028) had an adequate GFR range, while 27.8% (n=7166) of GFR measurements from patients older than 75 years old and 29.4% (n=913) of GFR measurements from patients younger than 75 years with GFR &lt;60\u2009mL\/min were within an adequate time range. Adherence to NOACs varied across different drugs, with 59.1% (n=540) adhering to edoxaban, 56.3% (n=5443) to rivaroxaban, 55.3% (n=3143) to dabigatran and 53.3% (n=4211) to apixaban.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dabigatran had the lowest percentage of guideline-consistent doses. Patients younger than 75 years with GFR &gt;60\u2009mL\/min had the highest percentage with an adequate GFR range, while other groups who require closer GFR monitoring had lower percentages within an adequate GFR range. Adherence to NOACs differed among different drugs, with greater adherence to treatment with edoxaban and less adherence to apixaban.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076108","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T12:44:30Z","timestamp":1714481070000},"page":"e076108","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Appropriateness of prescribing profiles and intake adherence to non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: analysis of a retrospective longitudinal study using real-world data from Northern Portugal (AF-React Study)"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-6251","authenticated-orcid":false,"given":"Susana","family":"Silva Pinto","sequence":"first","affiliation":[{"name":"S\u00e3o Tom\u00e9 Family Health Unit, Santo Tirso, Portugal"},{"name":"CINTESIS@RISE, University of Porto, Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal"}]},{"given":"Teresa S","family":"Henriques","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, University of Porto, Porto, Portugal"},{"name":"CI-IPOP (Health Research Network), Portuguese Oncoloy Institute of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-2220","authenticated-orcid":false,"given":"Andreia Sofia Costa","family":"Teixeira","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, University of Porto, Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal"},{"name":"ADiT-LAB, Instituto Polit\u00e9cnico de Viana do Castelo, Viana do Castelo, Portugal"}]},{"given":"Hugo","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Regional Health Administration of Northern Portugal, Ministry of Health, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-5167","authenticated-orcid":false,"given":"Carlos","family":"Martins","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, University of Porto, Porto, Portugal"},{"name":"H4A Primary Health Care Research Network, Porto, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"2025121513570066000_14.4.e076108.1","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s40620-019-00630-1","article-title":"Atrial fibrillation and chronic kidney disease conundrum: an update","volume":"32","author":"Tapoi","year":"2019","journal-title":"J Nephrol"},{"key":"2025121513570066000_14.4.e076108.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-040404","article-title":"AF-react study: atrial fibrillation management strategies in clinical practice\u2014retrospective longitudinal study from real-world data in northern Portugal","volume":"11","author":"Silva Pinto","year":"2021","journal-title":"BMJ Open"},{"key":"2025121513570066000_14.4.e076108.3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.thromres.2017.04.027","article-title":"Non-vitamin K-dependent oral anticoagulants (Noacs) in chronic kidney disease patients with atrial fibrillation","volume":"155","author":"Di Lullo","year":"2017","journal-title":"Thromb Res"},{"key":"2025121513570066000_14.4.e076108.4","doi-asserted-by":"crossref","first-page":"883","DOI":"10.4070\/kcj.2019.0234","article-title":"Reducing stroke risk in atrial fibrillation: adherence to guidelines has improved, but patient persistence with anticoagulant therapy remains suboptimal","volume":"49","author":"Lowres","year":"2019","journal-title":"Korean Circ 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