Suboptimal Use of Oral Anticoagulants in Atrial Fibrillation: Has the Introduction of Direct Oral Anticoagulants Improved Prescribing Practices?
| Autor: | Luke Bereznicki, Leanne Chalmers, Endalkachew Alamneh |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pyridines Pyridones MEDLINE Administration Oral 030204 cardiovascular system & hematology Risk Assessment Antithrombins 03 medical and health sciences 0302 clinical medicine Rivaroxaban Risk Factors Atrial Fibrillation Humans Medication Errors Medicine Pharmacology (medical) 030212 general & internal medicine Practice Patterns Physicians' Intensive care medicine Stroke Evidence-Based Medicine Dose-Response Relationship Drug business.industry Anticoagulants Atrial fibrillation General Medicine Evidence-based medicine medicine.disease Blood Coagulation Factors Dabigatran Thiazoles Systematic review Practice Guidelines as Topic Pyrazoles Observational study Warfarin Cardiology and Cardiovascular Medicine business Risk assessment Factor Xa Inhibitors |
| Zdroj: | American Journal of Cardiovascular Drugs. 16:183-200 |
| ISSN: | 1179-187X 1175-3277 |
| DOI: | 10.1007/s40256-016-0161-8 |
| Popis: | Atrial fibrillation (AF) and the associated risk of stroke are emerging epidemics throughout the world. Suboptimal use of oral anticoagulants for stroke prevention has been widely reported from observational studies. In recent years, direct oral anticoagulants (DOACs) have been introduced for thromboprophylaxis. We conducted a systematic literature review to evaluate current practices of anticoagulation in AF, pharmacologic features and adoption patterns of DOACs, their impacts on proportion of eligible patients with AF who receive oral anticoagulants, persisting challenges and future prospects for optimal anticoagulation. In conducting this review, we considered the results of relevant prospective and retrospective observational studies from real-world practice settings. PubMed (MEDLINE), Scopus (RIS), Google Scholar, EMBASE and Web of Science were used to source relevant literature. There were no date limitations, while language was limited to English. Selection was limited to articles from peer reviewed journals and related to our topic. Most studies identified in this review indicated suboptimal use of anticoagulants is a persisting challenge despite the availability of DOACs. Underuse of oral anticoagulants is apparent particularly in patients with a high risk of stroke. DOAC adoption trends are quite variable, with slow integration into clinical practice reported in most countries; there has been limited impact to date on prescribing practice. Available data from clinical practice suggest that suboptimal oral anticoagulant use in patients with AF and poor compliance with guidelines still remain commonplace despite transition to a new era of anticoagulation featuring DOACs. |
| Databáze: | OpenAIRE |
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