Anticoagulant treatment in primary health care in Finland

Abstract

Objective - To establish the prevalence of anticoagulant (AC) treatment, the indica-tions, and the quality of care in primary health care.

Design - A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records.

Setting - Eight Finnish health centres with a total population of 182 091 inhabitants. Results - A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmon-ary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges.

Conclusion - The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practioner's re-sponsibility functions well. The quality of care is good, even in older age groups.

Key Words:

• anticoagulant treatment
• atrial fibrillation
• Finland
• prevalence
• Warfarin
• primary health care
• quality assurance