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<td><h1><a name="h1" id="h1"></a>Pharmaceutical Research</h1>
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<h2>Physicians generally followed drug treatment guidelines for atrial fibrillation, but only one-third used warfarin</h2>
<p>Atrial fibrillation (AF) is a common type of irregular heart rhythm that can cause stroke and other problems. Treatment includes the use of cardiac rate-controlling drugs, such as beta-blockers, antiarrhythmic drugs, and anticoagulants such as warfarin to reduce the risk of stroke. During the study period, trends in the use of digoxin, beta-blockers, and Class Ia antiarrhythmic drugs for patients with AF generally followed the evidence-based recommendations. However, only about one-third (37 percent) of patient visits for AF included use of warfarin, even among patients who were 60 years and older.</p>
<p>The low and unchanging use of warfarin during the 4-year study period may indicate a need for physician education and intervention to improve use of warfarin and reduce patient risk of stroke, note the researchers. They analyzed medications mentioned by U.S. office-based physicians during visits with AF patients between 1999 and 2003, using data from the IMS Health National Disease and Therapeutic Index&#8482;.</p>
<p>Digoxin, considered to be the least effective rate-controlling drug in most AF patients, was the most commonly mentioned rate-controlling drug in 23 percent of patient visits, followed by beta-blockers in 11 percent, and calcium-channel blockers in 8 percent. During the study period, mentions of digoxin significantly decreased, and mentions of beta-blockers significantly increased, a practice change more in line with clinical evidence. Mentions of antiarrythmic drugs, most commonly amiodarone, were reported in an average of 12 percent of patient visits throughout the study period. </p>
<p>The study was supported in part by the Agency for Healthcare Research and Quality (HS10548).</p>
<p>More details are in "Outpatient use of anticoagulants, rate-controlling drugs, and antiarrhythmic drugs for atrial fibrillation," by Nancy M. Allen LaPointe, Pharm.D., Laura Governale, Pharm.D., M.B.A., Jerry Watkins, M.S., and others, in the November 2007 <em>American Heart Journal</em> 154, pp. 893-898.</p>
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