Abstract 215: Use of Chronic Medications among Patients with Non-Valvular Atrial Fibrillation

Introduction: Patients with non-valvular atrial fibrillation (NVAF) typically have other chronic comorbid conditions. However, little is known about the dosing regimens of medications that are prescribed to NVAF patients. Objectives: Estimate the proportion of real world NVAF patients with at least 1 CHADS2risk factor for stroke that may take chronic medications more than once per day. Methods: Using claims data from the Truven Health MarketScan® Commercial Claims and Encounters database, which contains health insurance claims data on a national sample of privately insured individuals, we identified NVAF patients with CHADS2≥ 1 during the period January 1, 2008 through September 30, 2012. Chronic medications were identified as those for which the patient had at least a 90 day supply during the study period, excluding oral anticoagulants. A “medication portfolio” was developed for each NVAF patient characterizing the chronic prescription medications taken on a regular basis. Information from the medication’s FDA approved product label and pharmacy claims data were used to add detail to each patient’s medication list. This detail included the medication name, recommended dosage and administration, and prescribed strength, quantity, and days supply. Patients were identified as taking medications multiple times per day if they were prescribed a medication with a >1 time per day dosing regimen per the product label, or one medication typically taken in the morning and another medication typically taken in the evening, or, in cases where the typical administration was unclear from the label or from clinical practice, were prescribed more than 1 pill per day, while the total daily strength of the medication was equal to an available strength of a single pill. The proportion of NVAF patients that took medications multiple times per day was then determined. Results: Overall, 324,172 NVAF patients were selected for the study. The mean age of the patients was 75.3 years and over half (54.6%) of the patients were male. Of these patients, 299,716 (92.5%) were prescribed chronic medications and 215,527 (66.5%) were identified as possibly taking medications more than once per day. Overall, among patients who were prescribed chronic medications, 71.9% were identified as possibly taking their medications more than once per day. Conclusion: Patients with NVAF typically have other chronic conditions and a large proportion of these patients may be on treatment regimens that require taking medications more than once per day.