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Ulrich, LR; Mergenthal, K; Petersen, JJ; Roehl, I; Rauck, S; Kemperdick, B; Schulz-Rothe, S; Berghold, A; Siebenhofer, A.
Anticoagulant treatment in German family practices - screening results from a cluster randomized controlled trial.
BMC Fam Pract. 2014; 15(10):170-170 Doi: 10.1186/s12875-014-0170-0 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Berghold Andrea
Siebenhofer-Kroitzsch Andrea

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Oral anticoagulation (OAC) with coumarins and new anticoagulants are highly effective in preventing thromboembolic complications. However, some studies indicate that over- and under-treatment with anticoagulants are fairly common. The aim of this paper is to assess the appropriateness of treatment in patients with a long-term indication for OAC, and to describe the corresponding characteristics of such patients on the basis of screening results from the cluster randomized PICANT trial. Randomly selected family practices in the federal state of Hesse, Germany, were visited by study team members. Eligible patients were screened using an anonymous patient list that was generated by the general practitioners' software according to predefined instructions. A documentation sheet was filled in for all screened patients. Eligible patients were classified into 3 categories (1: patients with a long-term indication for OAC and taking anticoagulants, 2: patients with a long-term indication for OAC but not taking anticoagulants, 3: patients without a long-term indication for OAC but taking an anticoagulant on a permanent basis). IBM SPSS Statistics 20 was used for descriptive statistical analysis. We screened 2,036 randomly selected, potentially eligible patients from 52 family practices. 275 patients could not be assigned to one of the 3 categories and were therefore not considered for analysis. The final study sample comprised 1,761 screened patients, 1,641 of whom belonged to category 1, 78 to category 2, and 42 to category 3. INR values were available for 1,504 patients of whom 1,013 presented INR values within their therapeutic ranges. The majority of screened patients had very good compliance, as assessed by the general practitioner. New antithrombotic drugs were prescribed in 6.1% of cases. The screening results showed that a high proportion of patients were receiving appropriate anticoagulation therapy. The numbers of patients with a long-term indication for OAC therapy that were not receiving oral anticoagulants, and without a long-term indication that were receiving OAC, were considerably lower than expected. Most patients take coumarins, and the quality of OAC control is reasonably high. Current Controlled Trials ISRCTN41847489.
Find related publications in this database (using NLM MeSH Indexing)
Administration, Oral -
Aged -
Aged, 80 and over -
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Benzimidazoles - therapeutic use
Coumarins - therapeutic use
Dabigatran -
Family Practice - standards
Female -
Female -
Guideline Adherence - statistics & numerical data
Heart Diseases - drug therapy
Heart Valve Prosthesis -
Humans -
International Normalized Ratio -
Male -
Mass Screening -
Middle Aged -
Morpholines - therapeutic use
Practice Guidelines as Topic -
Process Assessment (Health Care) -
Pulmonary Embolism - prevention & control
Pyrazoles - therapeutic use
Pyridones - therapeutic use
Rivaroxaban -
Stroke - etiology
Thiophenes - therapeutic use
Thromboembolism - prevention & control
Thrombosis - drug therapy
Venous Thromboembolism - prevention & control
beta-Alanine - analogs & derivatives

Find related publications in this database (Keywords)
Oral anticoagulation
Family practice
Cluster randomization
Health services research
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