Situación actual de los anticoagulantes orales de acción directa en atención primaria de España. Posicionamiento de SEMERGEN en 2023(Pag.-e 102136)

  1. J. Polo-García 1
  2. V. Pallares-Carratalá 2
  3. M. Turegano-Yedro 1
  4. J.C. Romero-Vigara 3
  5. M.A. Prieto-Díaz 4
  6. S. Cinza-Sanjurjo 5
  1. 1 Centro de Salud Casar de Cáceres, Casar de Cáceres, Cáceres, España
  2. 2 Universidad Jaime I, Castellón, España
  3. 3 Centro de Salud Alfajarín, Alfajarín, Zaragoza, España
  4. 4 Centro de Salud Vallobín-La Florida, Oviedo, España
  5. 5 Centro de Salud Milladoiro, Área de Salud de Santiago de Compostela.
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Ano de publicación: 2024

Número: 3

Páxinas: 6-6

Tipo: Artigo

DOI: 10.1016/J.SEMERG.2023.102136 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Semergen: revista española de medicina de familia

Resumo

La anticoagulación oral es clave para disminuir el riesgo de ictus en la fibrilación auricular. Aunque clásicamente los antagonistas de la vitamina K (AVK) se han empleado para este fin, han sido ampliamente superados por los anticoagulantes orales de acción directa (ACOD), como lo demuestran las evidencias provenientes de los ensayos clínicos, estudios de vida real y poblacionales. De hecho, todas las guías de práctica clínica recomiendan su uso de manera preferencial sobre los AVK. Sin embargo, en España la prescripción de los ACOD está subordinada a un visado de inspección que recoge las condiciones clínicas definidas en el Informe de Posicionamiento Terapéutico de la Agencia Española del Medicamento, y que todavía impone importantes restricciones a su uso, limitando los beneficios del empleo de los ACOD en los pacientes con fibrilación auricular (FA), y generando además inequidades entre las diferentes comunidades autónomas. De hecho, el empleo de los ACOD en España es muy inferior a los países de nuestro entorno. Esto ha provocado que en otros países ha disminuido la incidencia de ictus isquémico a nivel poblacional, junto con una reducción del coste por paciente con FA, pero en España este descenso ha sido discreto. Por todo ello, y en aras de la sostenibilidad del sistema sanitario, pedimos la eliminación del visado para que los ACOD se puedan prescribir de acuerdo a las recomendaciones realizadas por las guías. Además, también apostamos por el refuerzo de la formación y de las decisiones consensuadas con el paciente, siendo el médico de familia un actor clave en la protección del paciente con FA.

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