A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.

<h4>Background</h4>The incidence of atrial fibrillation (AF) is increasing, and effective anticoagulation therapy can prevent adverse events. Selecting the appropriate OAC based on patient characteristics has become a challenge. Interventions are going to be a potential area of focus.<...

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Autores principales:	Yiyi Qian, Jiajun Zhang, Jiangya Li, Zhiying Weng
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fa4c84eac4b344a3a46952a9588c24e0
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spelling	oai:doaj.org-article:fa4c84eac4b344a3a46952a9588c24e02021-12-02T20:07:38ZA retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.1932-620310.1371/journal.pone.0259199https://doaj.org/article/fa4c84eac4b344a3a46952a9588c24e02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259199https://doaj.org/toc/1932-6203<h4>Background</h4>The incidence of atrial fibrillation (AF) is increasing, and effective anticoagulation therapy can prevent adverse events. Selecting the appropriate OAC based on patient characteristics has become a challenge. Interventions are going to be a potential area of focus.<h4>Objectives</h4>To explore the discrepancies between clinician prescriptions and recommended guidelines of oral anticoagulants (OACs) for patients with atrial fibrillation (AF), and to provide direction for improving anticoagulation strategies for treating patients with AF.<h4>Materials and methods</h4>Data were collected from the electronic medical record system of Fuwai Yunnan Cardiovascular Hospital between July 2019 and January 2020. The suitability of prescribed OACs for patients with AF was assessed according to the Rules for Avoiding Prescription Inappropriateness, the prescribed medicine label, and any relevant antithrombotic guidelines for treating patients with AF.<h4>Results</h4>A total of 460 patients met the inclusion criteria. Of these, 53.7% received an appropriate prescription and 46.3% received an inappropriate prescription. Of the patients who received inappropriate prescriptions, 15.4% were prescribed without the presenting appropriate indicators, 1.3% were prescribed inappropriate drug selection, and 29.6% were prescribed inappropriate drug doses. For patients prescribed without providing appropriate indicators, 2.2% had no indication for medication and 13.3% had an indication for medication, but not a specific OAC. For patients with inappropriate drug selection, 1, 5 patients were on rivaroxaban, dabigatran respectively. The distribution of NOAC doses was as follows: dabigatran standard dose (45.2%), the low dose (54.8%). Rivaroxaban standard dose (58.9%), low dose (36.8%), high dose (4.3%). A total of 44 patients (9.6%) experienced bleeding events, 12 patients (2.6%) experienced embolic events, and 7 patients experienced other adverse events after dosing.<h4>Conclusions</h4>In clinical practice, it is common for patients with AF to receive inappropriate prescriptions of OACs. Therefore there is a need to enhance anticoagulation management in patients with AF to improve the appropriate use of OACs.Yiyi QianJiajun ZhangJiangya LiZhiying WengPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259199 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yiyi Qian Jiajun Zhang Jiangya Li Zhiying Weng A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
description	<h4>Background</h4>The incidence of atrial fibrillation (AF) is increasing, and effective anticoagulation therapy can prevent adverse events. Selecting the appropriate OAC based on patient characteristics has become a challenge. Interventions are going to be a potential area of focus.<h4>Objectives</h4>To explore the discrepancies between clinician prescriptions and recommended guidelines of oral anticoagulants (OACs) for patients with atrial fibrillation (AF), and to provide direction for improving anticoagulation strategies for treating patients with AF.<h4>Materials and methods</h4>Data were collected from the electronic medical record system of Fuwai Yunnan Cardiovascular Hospital between July 2019 and January 2020. The suitability of prescribed OACs for patients with AF was assessed according to the Rules for Avoiding Prescription Inappropriateness, the prescribed medicine label, and any relevant antithrombotic guidelines for treating patients with AF.<h4>Results</h4>A total of 460 patients met the inclusion criteria. Of these, 53.7% received an appropriate prescription and 46.3% received an inappropriate prescription. Of the patients who received inappropriate prescriptions, 15.4% were prescribed without the presenting appropriate indicators, 1.3% were prescribed inappropriate drug selection, and 29.6% were prescribed inappropriate drug doses. For patients prescribed without providing appropriate indicators, 2.2% had no indication for medication and 13.3% had an indication for medication, but not a specific OAC. For patients with inappropriate drug selection, 1, 5 patients were on rivaroxaban, dabigatran respectively. The distribution of NOAC doses was as follows: dabigatran standard dose (45.2%), the low dose (54.8%). Rivaroxaban standard dose (58.9%), low dose (36.8%), high dose (4.3%). A total of 44 patients (9.6%) experienced bleeding events, 12 patients (2.6%) experienced embolic events, and 7 patients experienced other adverse events after dosing.<h4>Conclusions</h4>In clinical practice, it is common for patients with AF to receive inappropriate prescriptions of OACs. Therefore there is a need to enhance anticoagulation management in patients with AF to improve the appropriate use of OACs.
format	article
author	Yiyi Qian Jiajun Zhang Jiangya Li Zhiying Weng
author_facet	Yiyi Qian Jiajun Zhang Jiangya Li Zhiying Weng
author_sort	Yiyi Qian
title	A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
title_short	A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
title_full	A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
title_fullStr	A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
title_full_unstemmed	A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
title_sort	retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/fa4c84eac4b344a3a46952a9588c24e0
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A retrospective study on the evaluation of the appropriateness of oral anticoagulant therapy for patients with atrial fibrillation.

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