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National underuse of anti-thrombotic therapy in chronic atrial fibrillation identified from digoxin prescribing.

AIMS
To examine if appropriate antithrombotic therapy in atrial fibrillation is implemented nationally.


METHODS
Using prescriptions for digoxin as a surrogate for atrial fibrillation, we identified its coprescription with antithrombotic therapy, aspirin or warfarin in a national prescribing database in 27 571 patients over 45 years old.


RESULTS
Proportionately significantly more men were on warfarin, and use in those >75 years old was three times less than in those <65 years. Reluctance to use antithrombotics was confirmed in a postal survey.


CONCLUSION
Data suggest a missed opportunity to prevent stroke with women and those >75 years old least likely to receive warfarin.