caa a22 4500 475819349 CHVBK 20180406123818.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s002280000221 doi (NATIONALLICENCE)springer-10.1007/s002280000221 Predictors for prophylactic antithrombotic prescribing in ischaemic heart disease and the impact of national guidelines [Elektronische Daten] [R. Fijn, A.G.G. Stuurman-Bieze, P.B. van den Berg, J.R.B.J. Brouwers, P.A. de Graeff, L.T.W. de Jong-van den Berg] Abstract.: Objectives: Assessment of predictors for initiating prophylactic antithrombotic prescribing for patients newly diagnosed with ischaemic heart disease (IHD) and the impact of the introduction of national guidelines. Design and setting: A retrospective case control study was performed using pharmacy prescription data from 120,000 Dutch patients over a 5-year period. IHD patients were identified using as a marker multiple nitrate prescriptions [anatomical-chemical-therapeutic (ATC) code C01D] indicating chronic use. Initiation of antithrombotic therapy was likewise identified using ATC codes B01AA and B01AC (oral anticoagulants and thrombocyte aggregation inhibitors), prescribed within 6months following the first nitrate prescription. Statistically significant (P<0.05) predictors were assessed using multivariable analysis considering patient, prescriber and medication characteristics. Results: Of the 2598 patients who met specified inclusion criteria for newly diagnosed IHD, approximately 35% was not prescribed any type of antithrombotic therapy. Male patients [odds ratio (OR) 2.4, 95% confidence interval (CI) 2.0-2.9], patients with cardiovascular (other than IHD) and diabetic co-morbidity (OR 6.4, 95% CI 4.8-7.9 and OR 1.6, 95% CI 1.1-2.1, respectively) and patients using isosorbide mononitrate rather than isosorbide dinitrate as anti-ischaemic main therapy (OR 2.1, 95% CI 1.3-2.5) were most likely to be prescribed antithrombotic therapy. Furthermore, initiating antithrombotic prescribing was more likely after the introduction of national guidelines (OR 1.4, 95% CI 1.1-1.7). Conclusions: Initiating antithrombotic prescribing in newly diagnosed IHD patients can be predicted by patient gender, certain co-morbidity and main type of nitrate therapy. The introduction of national guidelines has resulted in an increase of prophylactic antithrombotic prescribing in accordance with their contents. Springer-Verlag, 2000 Ischaemic heart disease Angina pectoris Myocardial infarction nationallicence Fijn R. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut Stuurman-Bieze A.G.G. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut van den Berg P.B. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut Brouwers J.R.B.J. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut de Graeff P.A. University Hospital Groningen and University of Groningen, Faculty of Medical Sciences, Department of Clinical Pharmacology, Groningen, The Netherlands aut de Jong-van den Berg L.T.W. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut European Journal of Clinical Pharmacology Springer-Verlag 56/9-10(2000-12-01), 739-746 0031-6970 56:9-10<739 2000 56 228 https://doi.org/10.1007/s002280000221 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280000221 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fijn R. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Stuurman-Bieze A.G.G. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut NATIONALLICENCE 700 1- van den Berg P.B. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Brouwers J.R.B.J. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut NATIONALLICENCE 700 1- de Graeff P.A. University Hospital Groningen and University of Groningen, Faculty of Medical Sciences, Department of Clinical Pharmacology, Groningen, The Netherlands aut NATIONALLICENCE 700 1- de Jong-van den Berg L.T.W. Groningen University Institute for Drug Exploration (GUIDE), University of Groningen, University Centre for Pharmacy, Department of Pharmaceutical Pharmacology and Clinical Pharmacy, Section of Social Pharmacy and Pharmacoepidemiology, Groningen, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Pharmacology Springer-Verlag 56/9-10(2000-12-01), 739-746 0031-6970 56:9-10<739 2000 56 228 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer