@article {Ritchiee43, author = {Leona A Ritchie and Stephanie L Harrison and Peter E Penson and Ashley Akbari and Fatemeh Torabi and Joe Hollinghurst and Daniel Harris and Oluwakayode B Oke and Asangaedem Akpan and Julian P Halcox and Sarah E Rodgers and Gregory YH Lip and Deirdre A Lane}, title = {Anticoagulation in older people with atrial fibrillation moving to care homes: a data linkage study}, volume = {73}, number = {726}, pages = {e43--e51}, year = {2023}, doi = {10.3399/BJGP.2022.0156}, publisher = {Royal College of General Practitioners}, abstract = {Background Treatment decisions about oral anticoagulants (OACs) for atrial fibrillation (AF) are complex in older care home residents.Aim To explore factors associated with OAC prescription.Design and setting Retrospective cohort study set in care homes in Wales, UK, listed in the Care Inspectorate Wales Registry 2017/18.Method Analysis of anonymised individual-level electronic health and administrative data was carried out on people aged >=65 years entering a care home between 1 January 2003 and 31 December 2018, provisioned from the Secure Anonymised Information Linkage Databank.Results Between 2003 and 2018, 14 493 people with AF aged >=65 years became new residents in care homes in Wales and 7057 (48.7\%) were prescribed OACs (32.7\% in 2003 compared with 72.7\% in 2018) within 6 months before care home entry. Increasing age and prescription of antiplatelet therapy were associated with lower odds of OAC prescription (adjusted odds ratio [aOR] 0.96 per 1-year age increase, 95\% confidence interval [CI] = 0.95 to 0.96 and aOR 0.91, 95\% CI = 0.84 to 0.98, respectively). Conversely, prior venous thromboembolism (aOR 4.06, 95\% CI = 3.17 to 5.20), advancing frailty (mild: aOR 4.61, 95\% CI = 3.95 to 5.38; moderate: aOR 6.69, 95\% CI = 5.74 to 7.80; and severe: aOR 8.42, 95\% CI = 7.16 to 9.90), and year of care home entry from 2011 onwards (aOR 1.91, 95\% CI = 1.76 to 2.06) were associated with higher odds of an OAC prescription.Conclusion There has been an increase in OAC prescribing in older people newly admitted to care homes with AF. This study provides an insight into the factors influencing OAC prescribing in this population.}, issn = {0960-1643}, URL = {https://bjgp.org/content/73/726/e43}, eprint = {https://bjgp.org/content/73/726/e43.full.pdf}, journal = {British Journal of General Practice} }