Evaluating equality in prescribing Novel Oral Anticoagulants (NOACs) in England: The protocol of a Bayesian small area analysis

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting about 1.6% of population in England. Novel oral anticoagulants (NOACs) are approved AF treatments that reduce stroke risk. In this study, we estimate equality individual NOAC prescriptions with high spatial resolution Clinical Commissioning Groups (CCGs) across England from 2014 to 2019. Methods A Bayesian spatio-temporal model will be used and predict prescription trend on ‘prescription data’ as an indicator health services utilisation, using a small area analysis methodology. The main dataset study “Practice Level Prescribing England,” which contains four NOACs prescribed by all registered GP practices We use defined daily dose (DDD) equivalent methodology, recommended World Health Organization (WHO), compare space time. Four licensed datasets summed per 1,000 patients at CCG-level over also adjust for covariates, such demographic data, Multiple Deprivation Index, rural-urban classification. aim employ extended BYM2 (space-time model) RStan package. Discussion This suggests new statistical modelling approach link socioeconomic data pharmacoepidemiologic data. Quantifying time differences allow evaluation inequalities NOACs. methodology help develop geographically targeted public interventions, campaigns, audits, or guidelines improve areas low prescription. can other medications, especially those chronic diseases must monitored