Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis
Background: Atrial fibrillation (AF) is strongly associated with clinical adversity, including increased hospitalization and bleeding and stroke events. We examined the effect of the SARS-2 Coronavirus 2019 (COVID-19) pandemic on such events in individuals with AF receiving oral anticoagulation. Met...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602222000131 |
| _version_ | 1828378596116267008 |
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| author | Inmaculada Hernandez Nico Gabriel Meiqi He Jingchuan Guo Mina Tadrous Katie J. Suda Jared W. Magnani |
| author_facet | Inmaculada Hernandez Nico Gabriel Meiqi He Jingchuan Guo Mina Tadrous Katie J. Suda Jared W. Magnani |
| author_sort | Inmaculada Hernandez |
| collection | DOAJ |
| description | Background: Atrial fibrillation (AF) is strongly associated with clinical adversity, including increased hospitalization and bleeding and stroke events. We examined the effect of the SARS-2 Coronavirus 2019 (COVID-19) pandemic on such events in individuals with AF receiving oral anticoagulation. Methods: We employed medical and pharmacy claims spanning 2018–2020 from a nationally representative U.S. database (IQVIA Longitudinal Prescription, Medical Claims, and Institutional Claims). We selected individuals receiving oral anticoagulation in 2018 for AF and followed them from 1/1/2019–7/8/2020 for clinical events. We constructed interrupted time-series analyses across 30-day intervals with Poisson regression models to determine the effect of the COVID-19 pandemic on clinical events. Results: The dataset included 1,439,145 individuals (half with age ≥75 years; 47.6% women) receiving oral anticoagulation. We determined a 19% decrease in emergency room visits following the pandemic declaration and 8% decrease in inpatient admissions. In contrast admissions for stroke and bleeding were not affected by the declaration of the pandemic. Discussion: These results describe the temporal effect of the COVID-19 pandemic on clinical adversity – hospitalizations, strokes, and bleeding events – in individuals receiving oral anticoagulation for AF. Our analysis quantifies the decrease in clinical adversity accompanying COVID-19 in a large, highly representative U.S. health claims database. |
| first_indexed | 2024-04-14T08:30:16Z |
| format | Article |
| id | doaj.art-b149cb3130cf414b9d051e9ab4ad2347 |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-14T08:30:16Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-b149cb3130cf414b9d051e9ab4ad23472022-12-22T02:03:57ZengElsevierAmerican Heart Journal Plus2666-60222022-01-0113100096Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysisInmaculada Hernandez0Nico Gabriel1Meiqi He2Jingchuan Guo3Mina Tadrous4Katie J. Suda5Jared W. Magnani6Division of Clinical Pharmacy, University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, United States of AmericaDivision of Clinical Pharmacy, University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, United States of AmericaDivision of Clinical Pharmacy, University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, United States of AmericaDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United States of AmericaLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CanadaCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States of America; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of AmericaDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America; Corresponding author at: Center for Research on Health Care, 3609 Forbes Avenue, Room 112, Pittsburgh, PA 15213, United States of America.Background: Atrial fibrillation (AF) is strongly associated with clinical adversity, including increased hospitalization and bleeding and stroke events. We examined the effect of the SARS-2 Coronavirus 2019 (COVID-19) pandemic on such events in individuals with AF receiving oral anticoagulation. Methods: We employed medical and pharmacy claims spanning 2018–2020 from a nationally representative U.S. database (IQVIA Longitudinal Prescription, Medical Claims, and Institutional Claims). We selected individuals receiving oral anticoagulation in 2018 for AF and followed them from 1/1/2019–7/8/2020 for clinical events. We constructed interrupted time-series analyses across 30-day intervals with Poisson regression models to determine the effect of the COVID-19 pandemic on clinical events. Results: The dataset included 1,439,145 individuals (half with age ≥75 years; 47.6% women) receiving oral anticoagulation. We determined a 19% decrease in emergency room visits following the pandemic declaration and 8% decrease in inpatient admissions. In contrast admissions for stroke and bleeding were not affected by the declaration of the pandemic. Discussion: These results describe the temporal effect of the COVID-19 pandemic on clinical adversity – hospitalizations, strokes, and bleeding events – in individuals receiving oral anticoagulation for AF. Our analysis quantifies the decrease in clinical adversity accompanying COVID-19 in a large, highly representative U.S. health claims database.http://www.sciencedirect.com/science/article/pii/S2666602222000131Atrial fibrillationCOVID-19StrokeBleeding |
| spellingShingle | Inmaculada Hernandez Nico Gabriel Meiqi He Jingchuan Guo Mina Tadrous Katie J. Suda Jared W. Magnani Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis American Heart Journal Plus Atrial fibrillation COVID-19 Stroke Bleeding |
| title | Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis |
| title_full | Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis |
| title_fullStr | Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis |
| title_full_unstemmed | Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis |
| title_short | Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis |
| title_sort | effect of the covid 19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation a nationally representative administrative health claims analysis |
| topic | Atrial fibrillation COVID-19 Stroke Bleeding |
| url | http://www.sciencedirect.com/science/article/pii/S2666602222000131 |
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