What is it about?
Since 2006, reforms have been implemented in Sweden that aim to increase freedom for patients to choose care providers and treatment. However, evaluations of Swedish healthcare system since such reforms have indicated socioeconomic inequalities in patient management and health outcomes. Since 2011, non-vitamin K antagonist oral anticoagulants (NOACs) – dabigatran, rivaroxaban and apixaban – have been available in Sweden as alternatives to warfarin for stroke prevention in atrial fibrillation (AF) and other indications. Although more expensive, this new class of drugs have more favourable benefit–risk profiles than warfarin and can be prescribed in fixed doses without routine monitoring of coagulation. We used data from linked national registers for the period 2011 to 2014 to investigate associations between sociodemographic factors and initial treatment with a NOAC vs. warfarin, the previous standard of care. Patients starting treatment with a NOAC were more likely to be highly educated, in the highest income quartile and have a leading professional occupation. Patients residing in rural areas were half as likely to start treatment with a NOAC as those in urban areas. Therefore, among Swedish patients with NVAF, those with high socioeconomic status and urban residence were more likely to start preventative treatment with a NOAC than warfarin. Future research should explore reasons for these inequalities in NOAC treatment.
Photo by Néstor Morales on Unsplash
Why is it important?
The Swedish healthcare system aims to provide equal access to care to all residents yet evidence suggests that patients with low socioeconomic status are less likely to receive new treatments.
Read the Original
This page is a summary of: Sociodemographic factors and choice of oral anticoagulant in patients with non-valvular atrial fibrillation in Sweden: a population-based cross-sectional study using data from national registers, BMC Cardiovascular Disorders, February 2019, Springer Science + Business Media, DOI: 10.1186/s12872-019-1029-z.
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