[Use of direct-acting oral anticoagulants in Primary Care in Spain. Positioning statement by SEMERGEN on the current situation].

Autor:	Llisterri Caro JL; Médico de Familia, Fundación de Investigación SEMERGEN, Madrid, España., Cinza-Sanjurjo S; Medicina Familiar y Comunitaria, Centro de Salud Porto do Son, Porto do Son, A Coruña, España. Electronic address: scinzas@semergen.es., Polo Garcia J; Medicina Familiar y Comunitaria, Centro de Salud Casar de Cáceres, Casar de Cáceres, Cáceres, España., Prieto Díaz MA; Medicina Familiar y Comunitaria, Centro de Salud Vallobín-La Florida, Oviedo, España.
Jazyk:	Spanish; Castilian
Zdroj:	Semergen [Semergen] 2019 Sep; Vol. 45 (6), pp. 413-429. Date of Electronic Publication: 2019 Jul 19.
DOI:	10.1016/j.semerg.2019.06.002
Abstrakt:	The direct-acting oral anticoagulants (DOACs) are drugs that have been shown to have a safety profile superior to the vitaminK antagonists (VKA). The prescribing of DOACs in Spain is subject to approval in the form of an inspection visa. This sets out the clinical conditions defined in the Spanish Medicines Agency Therapeutic Positioning Report (TPR) of 2013, updated in 2016. These recommendations do not coincide with those of the European Cardiology Society (2016), restricting the use of DOACs to a second-line treatment in the majority of cases. Furthermore, this TPR is applied differently in the Regional Autonomous Communities and even in different health areas. This leads to a wide variation in the prescribing conditions, causing territorial inequalities in accessibility to these drugs by patients. The removal of the visa, and the appropriateness of the prescription to the recommendations of the Clinical Practice guidelines are key aspects to neutralise the current administrative and clinical barriers for the efficient use of DOACs in Primary Care. SEMERGEN supports the boosting of the clinical training and alliance with the patients in order to promote awareness and knowledge of atrial fibrillation. (Copyright © 2019 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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