Burden of Illness in Atrial Fibrillation

Study Overview
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Brief Summary
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The overall goal of this retrospective registry study is to investigate the burden-of.illness in atrial fibrillation (AF) in Denmark. Several Danish registries will be utilized to collect information on the diseases epidemiology including incidence and prevalence of AF and stroke as well as a stroke risk stratification of the Danish AF-population, the clinical and economical burden (in terms of direct and indirect cost) of AF and stroke to Danish patients, healthcare providers / healthcare system and society as well as describing treatment patterns with anticoagulant agents and their consequences in terms of stroke, bleeds, death and according cost in a real-life setting.

Official Title
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Burden of Illness in Atrial Fibrillation in Denmark

Conditions
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Atrial Fibrillation

Intervention / Treatment
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* Drug: Standard of care in AF in Denmark


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary and secondary diagnosis with AF; The base population of AF patients will be identified in the National Patient Registry. For a given period of time (2000-2013, both years inclusive) all patients with a hospital contact (admission, outpatient visit or ER visit) and for whom AF was the primary or secondary diagnosis code (ICD10-code: DI480, DI481, DI482, DI483, DI484, DI489) will be included. Exclusion Criteria: Patients younger than 18 and older than 90 years of age.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AF patients in Denmark / Cohort 1<br>The base population of AF patients for diagnosis and health care utilization / resource use will be identified in the National Patient Registry. For a given period of time (2000-2013, both years inclusive) all patients with a hospital contact (admission, outpatient visit or ER visit) and for whom AF was the primary or secondary diagnosis code will be identified. Further Data sources used: Registry of Medicinal Product Statistics: for determining the individuals' use of prescription medicine DREAM database: for investigation of sickness benefit and productivity loss Statistics Denmark's databases: on social services from municipalities Cause of Death Registry: AF-patients or controls who died during the study period (2000-2013) Danish Civil Registry: used for identification of controls, holds information about age, gender | Drug: Standard of care in AF in Denmark<br>* As used in clinical practice, analysed as per drug class, not separate drugs.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with (non-valvular) AF in total Danish population and by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Number of newly diagnosed patients with (non-valvular) AF per year in total Danish population and by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Number of patients with (non-valvular) AF per Danish Region and by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Number of newly diagnosed patients with (non-valvular) AF per year and per Danish Region and by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Mortality among AF patients compared with that of the general population/the 'controls', if possible by gender and age group |  | up to 4 weeks | 
| Number of patients with stroke in (non-valvular) AF-patients in Denmark by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Number of newly diagnosed patients with stroke in (non-valvular) AF-patients per year in Denmark by gender and age groups 18-65, 66-75, 75+, 80+ |  | up to 4 weeks | 
| Mortality among stroke patients (in AF) compared with that of the population/the 'controls' and the total AF-population, if possible by gender and age group |  | up to 4 weeks | 
| Direct cost in AF (in total and per patient) | Costs due to: Patients' resource use in the primary care sector (GP-visits, etc.) Patients' resource use in the hospital sector, including specialized rehabilitation Patients' use of prescription medicine Cost will be shown: For Denmark Per Region including differences between Regions For differentiation by age group For differentiation by Region and age group, if possible based on sample sizes | up to 4 weeks | 
| Direct cost in AF-related stroke (in total and per patient) | Costs due to: Patients' resource use in the primary care sector (GP-visits, etc.) Patients' resource use in the hospital sector, including specialized rehabilitation Patients' use of prescription medicine Cost will be shown: For Denmark Per Region including differences between Regions For differentiation by age group For differentiation by Region and age group, if possible based on sample sizes | up to 4 weeks | 
| Indirect cost in AF (in total and per patient) | Costs due to: Patients' long-term absence from the labour force (only relevant for patients under 65 years of age) Patients' demand for home care and rehabilitation delivered by municipalities Cost will be shown: For Denmark Per Region including differences between Regions For differentiation by age group For differentiation by Region and age group, if possible based on sample sizes | up to 4 weeks | 
| Indirect cost in AF-related stroke (in total and per patient) | Costs due to: Patients' long-term absence from the labour force (only relevant for patients under 65 years of age) Patients' demand for home care and rehabilitation delivered by municipalities Cost will be shown: For Denmark Per Region including differences between Regions For differentiation by age group For differentiation by Region and age group, if possible based on sample sizes | up to 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with AF-related stroke rated per CHADS2-score (0 to 6) in Danish population | CHADS2-score: Congestive heart failure/left ventricular dysfunction, Hypertension, Age, Diabetes, Stroke (Doubled) | up to 4 weeks | 
| Percentage (%) of patients with AF-related stroke rated per CHADS2-score (0 to 6) in Danish population | CHADS2-score: Congestive heart failure/left ventricular dysfunction, Hypertension, Age, Diabetes, Stroke (Doubled) | up to 4 weeks | 
| Number of patients with AF-related stroke rated per average CHADS-score in Danish population |  | up to 4 weeks | 
| Percentage (%) of patients with AF-related stroke rated per average CHADS-score in Danish populationPercentage (%) of patients with AF-related stroke rated per average CHADS-score in Danish population |  | up to 4 weeks | 
| Number of patients with AF-related stroke rated per CH2ADS2-VASc-score (0 to 9) in Danish population |  | up to 4 weeks | 
| Percentage (%) of patients with AF-related stroke rated per CH2ADS2-VASc-score (0 to 9) in Danish population |  | up to 4 weeks | 
| Number of patients per HAS-BLED-score (0 to 9) in Danish AF-population |  | up to 4 weeks | 
| Percentage (%) of patients per HAS-BLED-score (0 to 9) in Danish AF-population |  | up to 4 weeks | 
| Number of patients per average HAS-BLED-score in Danish AF-population |  | up to 4 weeks | 
| Percentage (%) of patients per average HAS-BLED-score in Danish AF-population |  | up to 4 weeks | 
| Number of patients in total and per CH2ADS2-VASc-score receiving Acetylsalicylic Acid [ASA] |  | up to 4 weeks | 
| Number of patients in total and per CH2ADS2-VASc-score receiving warfarin |  | up to 4 weeks | 
| Number of patients in total and per CH2ADS2-VASc-score receiving any Novel Oral Anticoagulants [NOACs] |  | up to 4 weeks | 
| Number of patients in total and per CH2ADS2-VASc-score receiving no treatment |  | up to 4 weeks | 
| Percentage (%) of patients in total and per CH2ADS2-VASc-score receiving Acetylsalicylic Acid [ASA] |  | up to 4 weeks | 
| Percentage (%) of patients in total and per CH2ADS2-VASc-score receiving Warfarin |  | up to 4 weeks | 
| Percentage (%) of patients in total and per CH2ADS2-VASc-score receiving any Novel Oral Anticoagulants [NOACs] |  | up to 4 weeks | 
| Percentage (%) of patients in total and per CH2ADS2-VASc-score receiving no treatment |  | up to 4 weeks | 
| Number of patients experiencing events (e.g. stroke, Systemic Embolism [SE], Myocardial Infarction [MI], bleeds, death) since AF-diagnosis per anticoagulant agent (AC)-medication incl. no treatment in total |  | up to 4 weeks | 
| Percentage (%) of patients experiencing events (e.g. stroke, Systemic Embolism [SE], Myocardial Infarction [MI], bleeds, death) since AF-diagnosis per anticoagulant agent (AC)-medication incl. no treatment in total |  | up to 4 weeks | 
| Number of patients experiencing events (e.g. stroke, Systemic Embolism [SE], Myocardial Infarction [MI], bleeds, death) since AF-diagnosis per Anticoagulant agent (AC)-medication incl. no treatment per CHADS-VASc-score |  | up to 4 weeks | 
| Percentage (%) of patients experiencing events (e.g. stroke, Systemic Embolism [SE], Myocardial Infarction [MI], bleeds, death) since AF-diagnosis per Anticoagulant agent (AC)-medication incl. no treatment per CHADS-VASc-score |  | up to 4 weeks | 
| Vitamin K antagonist (VKA) treated AF-patients in AC-clinics versus GP-setting | Based on data from the National Patient Registry, the Primary Care Registry and the Registry of Medicinal Product Statistics and inclusion codes for specific fees/services, it will be possible to identify which patients are treated in an AC-clinic and which patients are treated in a GP-setting | up to 4 weeks | 
| Direct and indirect cost of AC medication treatment patterns |  | up to 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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non-valvular Atrial Fibrillation