Digital Transformation

The amount of literature on Digital Transformation is staggering—and it keeps growing. Why, then, come out with yet another such document? Moreover, any text aiming at explaining the Digital Transformation by presenting a snapshot is going to become obsolete in a blink of an eye, most likely to be already obsolete at the time it is first published. The FDC Initiative on Digital Reality felt there is a need to look at the Digital Transformation from the point of view of a profound change that is pervading the entire society—a change made possible by technology and that keeps changing due to technology evolution opening new possibilities but is also a change happening because it has strong economic reasons. The direction of this change is not easy to predict because it is steered by a cultural evolution of society, an evolution that is happening in niches and that may expand rapidly to larger constituencies and as rapidly may fade away. This creation, selection by experimentation, adoption, and sudden disappearance, is what makes the whole scenario so unpredictable and continuously changing.The amount of literature on Digital Transformation is staggering—and it keeps growing. Why, then, come out with yet another such document? Moreover, any text aiming at explaining the Digital Transformation by presenting a snapshot is going to become obsolete in a blink of an eye, most likely to be already obsolete at the time it is first published. The FDC Initiative on Digital Reality felt there is a need to look at the Digital Transformation from the point of view of a profound change that is pervading the entire society—a change made possible by technology and that keeps changing due to technology evolution opening new possibilities but is also a change happening because it has strong economic reasons. The direction of this change is not easy to predict because it is steered by a cultural evolution of society, an evolution that is happening in niches and that may expand rapidly to larger constituencies and as rapidly may fade away. This creation, selection by experimentation, adoption, and sudden disappearance, is what makes the whole scenario so unpredictable and continuously changing

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Patient- and physician-related risk factors for hyperkalaemia in potassium-increasing drug-drug interactions

PURPOSE: Hyperkalaemia due to potassium-increasing drug-drug interactions (DDIs) is a clinically important adverse drug event. The purpose of this study was to identify patient- and physician-related risk factors for the development of hyperkalaemia. METHODS: The risk for adult patients hospitalised in the University Hospital Zurich between 1 December 2009 and 31 December 2011 of developing hyperkalaemia was correlated with patient characteristics, number, type and duration of potassium-increasing DDIs and frequency of serum potassium monitoring. RESULTS: The 76,467 patients included in this study were prescribed 8,413 potentially severe potassium-increasing DDIs. Patient-related characteristics associated with the development of hyperkalaemia were pulmonary allograft [relative risk (RR) 5.1; p 48 h: RR 1.6; p < 0.01). CONCLUSION: Strategies for reducing the risk of hyperkalaemia during potassium-increasing DDIs should consider both patient- and physician-related risk factors