It’s been a year and a day or two since my husband’s mother died, and frequently we think about her stroke and its effect on the last 30 months of her life. To support the health of our other senior parents and to be sure we know enough to be advocates for our own health, my husband and I try to learn as much as we can about strokes and how to prevent them.
Today I read a Reuters Health article, Warfarin May be Underused to Prevent Strokes, reporting on a study published in the journal Stroke. The journal article, Cost Efficiency of Anticoagulation With Warfarin to Prevent Stroke in Medicare Beneficiaries With Nonvalvular Atrial Fibrillation (abstract), points out that, “Approximately 2.3 million people in the United States are currently diagnosed with atrial fibrillation (AF).” Many of those people, for various reasons, are not treated with anti-coagulant medications such as warfarin, even though AF is associated with increased risk of stroke, and the drugs may decrease the risk.
The study, funded by a company, Boehringer Ingelheim Pharmaceuticals, Inc., which has just received approval to market a similar medication, used data from Medicare claims in 2004 and 2005.
My husband’s mother had atrial fibrillation, but for whatever reason, was not treated with an anticoagulant medication. Eventually the stroke occurred, and though she made progress in various ways, for the remaining three years of her life she required various levels of support and caregiving. (Read about AF: American Heart Association, Mayo Clinic, National Heart Lung and Blood Institute.)
Of course, it is easy to look back and wonder why she was not treated prior to the stroke, but, more importantly, others in my family want to be aware of AF and of the proactive steps that can be taken to treat the condition. The journal article concludes that treating older AF patients with the medications such as warfarin can reduce the occurrence of strokes so that many more people can avoid the expensive treatments that stroke patients require. The researchers write:
“After accounting for differences in patient characteristics and balancing the differential rates of adverse events plus the costs of treatment with warfarin, …the total healthcare savings was nearly $10,000/y per patient for patients taking warfarin.”
The Reuters article quotes Catherine J. Mercaldi, an epidemiologist and lead author, who says, “When warfarin is prescribed correctly, it is cost-effective, and if it was used more in the (AF) population and used appropriately, then we’d see even bigger reductions in cost.”