Abstract
Abstract only
Objective:
To evaluate the annual healthcare burden associated with dyspepsia among nonvalvular atrial fibrillation (NVAF) patients
Methods:
NVAF patients ≥18 years of age with continuous medical/prescription coverage were identified (1/1/2007-12/31/2009) from the
MarketScan
® Commercial and Medicare Research Databases. Patients with at least 1 inpatient or 2 outpatient dyspepsia diagnoses within 12 months following any NVAF diagnosis were grouped into the dyspeptic cohort, with patients without any dyspepsia diagnosis during the entire study period grouped into the non-dyspeptic cohort. The date of first dyspepsia diagnosis after NVAF diagnosis and a random date within 12 months after NVAF diagnosis were selected as the index dates for dyspeptic and non-dyspeptic patients, respectively. Baseline and follow-up periods were each 12 months. Of the overall dyspeptic and non-dyspeptic cohorts, patients were matched (1:1) by key patient characteristics. The dyspeptic cohort was further categorized as having a prior history of dyspepsia (chronic) or no dyspepsia (non-chronic) during the baseline period. Healthcare utilization and costs were evaluated and compared during the follow-up for matched cohorts.
Results:
Of 142,322 NVAF patients included in the overall study population (mean age: dyspeptic: 73.68, non-dyspeptic: 72.09 years, p<0.001), 10.2% were diagnosed with dyspepsia, with 67% of them having no history of prior dyspepsia during the baseline. Among the matched study population (N=28,172), patients had similar baseline characteristics: mean Charlson Comorbidity Index score of 2.3 in both cohorts and mean CHADS
2
scores of 1.9 and 1.8 for the non-dyspeptic and dyspeptic cohort, respectively. During the follow-up period, healthcare resource utilization and related costs were significantly greater for the dyspeptic cohort vs. the non-dyspeptic cohort (Table). Patients with chronic dyspepsia were the least likely to receive warfarin in the follow-up period (non-dyspeptic: 57.2%, non-chronic: 50.4%, chronic: 46.6%, p<0.001).
Conclusions:
NVAF patients with dyspepsia used healthcare resources to a greater extent and had greater healthcare costs than NVAF patients without dyspepsia. Warfarin usage appeared to be lower among NVAF patients with dyspepsia.