Differences in the quality of oral anticoagulation therapy with vitamin K antagonists in German GP practices – results of the cluster-randomized PICANT trial (Primary Care Management for Optimized Antithrombotic Treatment)

Mertens, Cornelia; Siebenhofer, Andrea; Berghold, Andrea; Pregartner, Gudrun; Ulrich, Lisa-Rebekka; Mergenthal, Karola; Kemperdick, Birgit; Schulz-Rothe, Sylvia; Rauck, Sandra; Harder, Sebastian; Gerlach, Ferdinand Michael; Petersen, Juliana Johanna

doi:10.1186/s12913-019-4372-y

Table 7 Linear mixed model analyses (TTR calculation based on GP-based target ranges)^a – patient-level covariates

From: Differences in the quality of oral anticoagulation therapy with vitamin K antagonists in German GP practices – results of the cluster-randomized PICANT trial (Primary Care Management for Optimized Antithrombotic Treatment)

Variables	Regression coefficient	95% confidence interval	P value^b	R ²
Age, years^c	−0.13	− 0.27; 0.01	0.060	0.10
Male gender	3.14	0.56; 5.72	0.017	0.11
Educational attainment			0.161	0.12
No educational attainment	Reference
Vocational training	−32.54	−66.17; 1.09
Vocational on-the-job training	3.19	−0.93; 7.31
On-the-job training combined with school-based education	−0.32	−5.45; 4.80
Education in a technical college	3.84	−1.19; 8.86
Polytechnic degree	1.90	−4.37; 8.17
University degree	5.34	−1.02; 11.69
BMI, units	0.15	−0.11; 0.42	0.252	0.09
Smoking			0.962	0.09
Non-smoker	Reference
Former smoker	−0.25	−2.96; 2.47
Occasional smoker	0.74	−7.51; 8.99
Regular smoker	− 2.24	−9.00; 4.51
CHA2DS2-VASc-Score > 1^d	3.90	−4.61; 12.40	0.368	0.10
Long-term indication for oral anticoagulation therapy^e
Atrial fibrillation /flutter	1.90	−1.34; 5.15	0.250	0.09
Recurrent venous thromboembolism	−0.85	−5.17; 3.47	0.699	0.09
Recurrent pulmonary embolism	−2.55	−7.14; 2.04	0.275	0.09
Mechanical heart prosthesis	−2.36	−7.05; 2.32	0.322	0.09
Intracardiac thrombus	−0.93	−13.77; 11.90	0.886	0.09
Comorbidities^e
Ischemic heart disease	−3.28	−6.08; −0.49	0.022	0.10
Cerebral insult / bleeding	−2.24	−5.72; 1.24	0.206	0.09
Congestive heart failure	−3.77	−6.64; −0.90	0.010	0.10
Peripheral arterial occlusive disease (PAOD)	−2.19	−6.75; 2.37	0.346	0.09
Arterial hypertension	−0.25	−3.85; 3.35	0.893	0.09
Renal insufficiency	−5.26	−8.69; −1.84	0.003	0.11
Diabetes mellitus	−2.01	−4.70; 0.67	0.141	0.10
Chronic pulmonary diseases	−5.49	−8.88; −2.11	0.002	0.11
Diseases of the esophagus, stomach, duodenum	−0.73	−4.17; 2.72	0.679	0.09
Malignant tumor	−3.66	−9.13; 1.81	0.190	0.09
Compliance^f
Not compliant	Reference
Moderately compliant	6.89	−1.64; 15.42	0.007	0.12
Highly compliant	11.22	3.11; 19.32
Self-measurement (n = 648)^g
No	Reference
Yes	6.17	2.76; 9.59	< 0.001	0.12
Hospitalization
No	Reference
Yes	−4.58	−7.13; −2.03	< 0.001	0.11
Number of days of hospitalization^h
Per day	−0.09	−0.14; −0.03	0.001	0.11
Occurrence of primary endpointⁱ	−4.42	−8.44; − 0.39	0.032	0.10

^aThese analyses are based on n = 688 patients and the models are adjusted via randomization group
^bp values marked in bold are statistically significant based on a significance level of 0.05
^cAge was calculated from 15/mm/yyyy since the exact birth date was not documented to ensure data privacy
^dReference category “= 1” because no “= 0” exists
^ePatients may have had more than one indication and/or more than one comorbidity
^fCompliance was assessed for each patient by his GP
^gDistinction between self-measurement yes and no, dose adjustment not taken into account
^h“Days in hospital in total” (during the study period)
ⁱprimary endpoint = combination of all thromboembolic events requiring hospitalization and major bleeding complications, as documented by GPs in the case report form (if more than one event occurred in a patient, the earliest event was considered)

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ISSN: 1472-6963

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