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Provider specialty and atrial fibrillation treatment strategies in United States community practice: findings from the ORBIT-AF registry.

dc.contributor.author Fosbøl, Emil
dc.contributor.author Gersh, Bernard John
dc.contributor.author Holmes, DaJuanicia
dc.contributor.author Kowey, Peter R
dc.contributor.author Mahaffey, Kenneth William
dc.contributor.author Mills, RM
dc.contributor.author ORBIT-AF Investigators and Patients
dc.contributor.author Peterson, Eric David
dc.contributor.author Piccini, Jonathan Paul Sr
dc.contributor.author Reiffel, JA
dc.contributor.author Thomas, Laine Elliott
dc.coverage.spatial England
dc.date.accessioned 2017-07-06T15:47:07Z
dc.date.available 2017-07-06T15:47:07Z
dc.date.issued 2013-07-18
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/23868192
dc.identifier jah3259
dc.identifier.uri http://hdl.handle.net/10161/15011
dc.description.abstract BACKGROUND: The prevalence of atrial fibrillation (AF) continues to increase; however, there are limited data describing the division of care among practitioners in the community and whether care differs depending on provider specialty. METHODS AND RESULTS: Using the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF) Registry, we described patient characteristics and AF management strategies in ambulatory clinic practice settings, including electrophysiology (EP), general cardiology, and primary care. A total of 10 097 patients were included; of these, 1544 (15.3%) were cared for by an EP provider, 6584 (65.2%) by a cardiology provider, and 1969 (19.5%) by an internal medicine/primary care provider. Compared with those patients who were cared for by cardiologists or internal medicine/primary care providers, patients cared for by EP providers were younger (median age, 73 years [interquartile range, IQR, 64, 80 years, Q1, Q3] versus 75 years [IQR, 67, 82 years] for cardiology and versus 76 years [IQR, 68, 82 years] for primary care). Compared with cardiology and internal medicine/primary care providers, EP providers used rhythm control (versus rate control) management more often (44.2% versus 29.7% and 28.8%, respectively, P<0.0001; adjusted odds ratio [OR] EP versus cardiology, 1.66 [95% confidence interval, CI, 1.05 to 2.61]; adjusted OR for internal medicine/primary care versus cardiology, 0.91 [95% CI, 0.65 to 1.26]). Use of oral anticoagulant therapy was high across all providers, although it was higher for cardiology and EP providers (overall, 76.1%; P=0.02 for difference between groups). CONCLUSIONS: Our data demonstrate important differences between provider specialties, the demographics of the AF patient population treated, and treatment strategies-particularly for rhythm control and anticoagulation therapy.
dc.language eng
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.113.000110
dc.subject ORBIT‐AF
dc.subject antithrombotic therapy
dc.subject atrial fibrillation
dc.subject outpatient
dc.subject provider
dc.subject specialty
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Ambulatory Care
dc.subject Anti-Arrhythmia Agents
dc.subject Anticoagulants
dc.subject Atrial Fibrillation
dc.subject Cardiology
dc.subject Community Health Services
dc.subject Female
dc.subject Humans
dc.subject Incidence
dc.subject Internal Medicine
dc.subject Male
dc.subject Medicine
dc.subject Middle Aged
dc.subject Physicians
dc.subject Practice Patterns, Physicians'
dc.subject Prevalence
dc.subject Primary Health Care
dc.subject Prospective Studies
dc.subject Registries
dc.subject United States
dc.title Provider specialty and atrial fibrillation treatment strategies in United States community practice: findings from the ORBIT-AF registry.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/23868192
pubs.begin-page e000110
pubs.issue 4
pubs.organisational-group Basic Science Departments
pubs.organisational-group Biostatistics & Bioinformatics
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 2
dc.identifier.eissn 2047-9980


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