Geographic Variation in Anticoagulant Use and Resident, Nursing Home, and County Characteristics Associated With Treatment Among US Nursing Home Residents.

This was a cross-sectional claims study, so it cannot show why a resident was or was not anticoagulated, or whether treatment prevented stroke or bleeding. Anticoagulant use was measured only on December 31 in 2014, 2015, and 2016, so it does not describe longer-term adherence or changes over time. Counties with fewer than 11 eligible residents were excluded, so the findings do not apply to sparsely populated rural areas, largely in the West and Mountain West. Over-the-counter medications, including aspirin, were not captured in Medicare Part D claims. Other resident, family, provider, and nursing home factors that may influence treatment were not available. Most nursing homes contributed 10 or fewer residents, so the analysis was done at county level rather than nursing home level.

No funding or conflict-of-interest declaration is included in the supplied article text. The publication types list NIH extramural research support.

Do not conclude that residents with atrial fibrillation who are not on anticoagulants are being harmed or protected. The study reports who was treated and what was associated with treatment, not stroke or bleeding outcomes.