Non-vitamin K antagonist oral anticoagulant (NOAC) use and dosing in Canadian practice: Insights from the optimising pharmacotherapy in the management approach to lowering risk in atrial fibrillation (OPTIMAL AF) Programme.
Administration, Oral
Aged
Aged, 80 and over
Anticoagulants
/ administration & dosage
Atrial Fibrillation
/ drug therapy
Canada
Cohort Studies
Female
Guideline Adherence
Humans
Male
Off-Label Use
/ statistics & numerical data
Practice Patterns, Physicians'
Stroke
/ prevention & control
Vitamin K
/ antagonists & inhibitors
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
20
04
2020
accepted:
15
07
2020
entrez:
15
1
2021
pubmed:
16
1
2021
medline:
6
3
2021
Statut:
ppublish
Résumé
To estimate the rate of non-vitamin K oral anticoagulant (NOAC) dosing that is lower- and higher-than-recommended and to describe the reasons for NOAC dose discordance with Health Canada prescribing information. The OPTIMAL AF Programme was an observational cohort quality assessment initiative in which primary and specialty care physicians in eight provinces provided a snapshot of their anticoagulated non-valvular atrial fibrillation (NVAF) patients through either an electronic medical record (EMR) system or standardised, paper-based data collection methods. Data on 1681 NVAF patients receiving oral anticoagulation (OAC) for stroke prevention was provided by 102 physicians. A NOAC was prescribed in 1379 patients (8%). The standard recommended dose was prescribed in 849 (76%) and reduced dose in 264 (24%). Concordance of the reduced dose with Health Canada prescribing information occurred in 154 patients (58%). The standard dose was concordant in 805 (95%). The main reasons for the use of discordant reduced doses were age of 80 years or more, elevated creatinine, prior bleeding or dose recommended by specialist. The vast majority of Canadian patients meeting the Canadian Cardiovascular Society (CCS) guideline recommendations for OAC to decrease AF-related stroke risk were receiving product monograph-concordant NOAC dosing (85%). Nonetheless, this highlights the fact that an important proportion of patients were prescribed doses that are discordant and opportunities remain to improve NOAC dosing to optimise stroke prevention.
Substances chimiques
Anticoagulants
0
Vitamin K
12001-79-5
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13625Subventions
Organisme : BMS Pfizer Alliance
Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
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