Inappropriate prescriptions of direct oral anticoagulants (DOACs) in hospitalized patients: A narrative review.

Autor: van der Horst SFB; Department of Medicine - Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, Netherlands. Electronic address: s.f.b.van_der_horst@lumc.nl., van Rein N; Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands., van Mens TE; Department of Medicine - Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, Netherlands; Amsterdam UMC, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, Netherlands., Huisman MV; Department of Medicine - Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, Netherlands., Klok FA; Department of Medicine - Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, Netherlands.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2023 Nov; Vol. 231, pp. 135-140. Date of Electronic Publication: 2023 Mar 27.
DOI: 10.1016/j.thromres.2023.03.007
Abstrakt: Direct oral anticoagulants (DOACs) have become the cornerstone for prevention of thromboembolic events in patients with atrial fibrillation and patients with a history of venous thromboembolism. However, studies show that DOAC prescriptions are commonly inconsistent with guideline recommendations. DOAC dosing in the acutely ill patient could impose an even greater challenge. In this review, we describe the prevalence of inappropriate inpatient prescribing of DOACs and the associated rationales, predictors and clinical consequences. With the aim of promoting appropriate prescriptions of DOACs to hospitalized patients, we further outline DOAC dose reduction criteria justified by various guidelines, illustrating the complexities of appropriate dosing, especially in acutely ill patients. Moreover, we will discuss the impact of anticoagulant stewardship programs and the vital role that pharmacists may play in optimizing inpatient DOAC treatment.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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