Pharmacoepidemiology and drug safety · 2026
Oral Anticoagulant Use Among Older Adults in Long-Term Care Facilities: Trends Over Time and Impact of High-Risk Comorbidities.
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Harrison S L, Inacio M C, Air T, Lang C, Sluggett J K, Whitehead C, Caughey G E
Аннотация
PURPOSE: To examine oral anticoagulant (OAC) use in older adults residing in long-term care facilities (LTCFs) since direct OACs (DOACs) were introduced, including trends over time and in people with high-risk comorbidities (prior gastrointestinal bleed and dementia).
METHODS: A repeated cross-sectional study using the Registry of Senior Australians National Historical Cohort was conducted and included individuals aged ≥ 65 years residing in LTCFs in Australia between 2013 and 2019. Yearly age- and sex-adjusted prevalence of OACs and 95% confidence intervals (CIs) were estimated using generalised estimating equation (GEE) Poisson models and adjusted prevalence ratios (aPRs) were calculated to estimate trends.
RESULTS: In 500 883 individuals, the prevalence of OAC use increased from 12.2% (95% CI 12.1-12.4) in 2013 to 16.5% (95% CI 16.4-16.7) in 2019 [aPR 1.05 (95% CI 1.05-1.05)]. This was driven by an increase in the use of DOACs, from 2.24% (95% CI 2.19-2.29) to 12.5% (95% CI 12.3-12.6) [aPR 1.25 (95% CI 1.25-1.26)]. Increases in OAC use were also observed in people with prior gastrointestinal bleed, from 12.9% (95% CI 11.8-13.9) to 17.1% (95% CI 16.2-17.9) [aPR 1.05 (95% CI 1.03-1.06)]. The use of OACs increased over the study period for people living with dementia from 9.93% to 12.8% [aPR 1.04 (95% CI 1.04-1.05)], and for people without dementia from 15.7% to 21.7% [aPR 1.06 (95% CI 1.06-1.06)].
CONCLUSIONS: This population-based study showed increasing use of OACs among residents of LTCFs, including in higher-risk comorbidity groups, indicating growing confidence in the use of DOACs in these groups.
METHODS: A repeated cross-sectional study using the Registry of Senior Australians National Historical Cohort was conducted and included individuals aged ≥ 65 years residing in LTCFs in Australia between 2013 and 2019. Yearly age- and sex-adjusted prevalence of OACs and 95% confidence intervals (CIs) were estimated using generalised estimating equation (GEE) Poisson models and adjusted prevalence ratios (aPRs) were calculated to estimate trends.
RESULTS: In 500 883 individuals, the prevalence of OAC use increased from 12.2% (95% CI 12.1-12.4) in 2013 to 16.5% (95% CI 16.4-16.7) in 2019 [aPR 1.05 (95% CI 1.05-1.05)]. This was driven by an increase in the use of DOACs, from 2.24% (95% CI 2.19-2.29) to 12.5% (95% CI 12.3-12.6) [aPR 1.25 (95% CI 1.25-1.26)]. Increases in OAC use were also observed in people with prior gastrointestinal bleed, from 12.9% (95% CI 11.8-13.9) to 17.1% (95% CI 16.2-17.9) [aPR 1.05 (95% CI 1.03-1.06)]. The use of OACs increased over the study period for people living with dementia from 9.93% to 12.8% [aPR 1.04 (95% CI 1.04-1.05)], and for people without dementia from 15.7% to 21.7% [aPR 1.06 (95% CI 1.06-1.06)].
CONCLUSIONS: This population-based study showed increasing use of OACs among residents of LTCFs, including in higher-risk comorbidity groups, indicating growing confidence in the use of DOACs in these groups.