Strengths and limitations
This was the first AF study conducted using MedicineInsight dataset,
which provided a large and national study population and thus enabled an
more complete description of the GP prescribing of OACs in Australia
(Gonzalez-Chica, Vanlint, Hoon & Stocks, 2018; MedicineInsight, 2018;
Radford et al., 2018). Furthermore, ten-year sequential cross-sectional
analyses enabled characterising the longitudinal trends in OAC
prescribing.
The study has several limitations. The MedicineInsight dataset contains
only records of medications prescribed by general practitioners.
However, general practitioners in Australia typically continue those
medications prescribed by cardiologists and so the trends described in
this study may still be considered accurate and useful with regard to
overall OAC prescribing. We did not account for medication
contraindications and adverse drug reactions that may have prevented
general practitioners from prescribing an OAC.
In this study, we used the guidelines retrospectively. For instance,
before 2012, OAC treatment was recommended for patients at moderate to
high stroke risk, and aspirin was widely used for patients at low stroke
risk (Camm et al., 2010). However, the guidelines used for this analysis
were in use for most of the study period and are appropriate to evaluate
the trends.