National underuse of anti-thrombotic therapy in chronic atrial fibrillation identified from digoxin prescribing

Br J Clin Pharmacol. 2007 Nov;64(5):706-9. doi: 10.1111/j.1365-2125.2007.02954.x. Epub 2007 Jun 6.


Aims: To examine if appropriate antithrombotic therapy in atrial fibrillation is implemented nationally.

Methods: Using prescriptions for digoxin as a surrogate for atrial fibrillation, we identified its coprescription with antithrombotic therapy, aspirin or warfarin in a national prescribing database in 27 571 patients over 45 years old.

Results: Proportionately significantly more men were on warfarin, and use in those >75 years old was three times less than in those <65 years. Reluctance to use antithrombotics was confirmed in a postal survey.

Conclusion: Data suggest a missed opportunity to prevent stroke with women and those >75 years old least likely to receive warfarin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Aspirin / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / economics
  • Cyclooxygenase Inhibitors / therapeutic use
  • Digoxin / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sex Factors
  • Thrombosis / drug therapy*
  • Thrombosis / epidemiology
  • Treatment Outcome
  • Warfarin / therapeutic use*


  • Anti-Arrhythmia Agents
  • Anticoagulants
  • Cyclooxygenase Inhibitors
  • Warfarin
  • Digoxin
  • Aspirin