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A recently published review of Medicaid claims in Ohio between 1997 and 2002 showed that African American patients with newly diagnosed nonvalvular atrial fibrillation (AF) were 25% less likely to fill prescriptions for warfarin than their Caucasian counterparts. Clinical predictors of warfarin use for nonvalvular AF have been welldescribed in previous studies, but little is known about racial disparities in warfarin prescribing.
The main outcome measure of the study was the filling of a warfarin prescription at any time between 7 days prior to and 30 days after the diagnosis of AF. The authors identified 6283 patients with a new diagnosis of AF, 18.5% of whom were African American. Prescriptions were filled by 9.4% of Caucasian patients and 7.6% of African American patients. The 2 strongest predictors of filling the prescription were inpatient diagnosis of AF and having 2 or more outpatient visits in the year prior to diagnosis.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.