Abstract
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. 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. 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. 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. 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.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and can lead to stroke, one of the most common and severe complications of atrial fibrillation (AF) [1]
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 oral anticoagulants (OACs)
For patients with inappropriate drug selection, 1, 5 patients were on rivaroxaban, dabigatran respectively
Summary
Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and can lead to stroke, one of the most common and severe complications of AF [1]. Stroke is characterized by high rates of disability, mortality and morbidity [3]. It places a significant burden on the healthcare systems, patients and their families [2]. Anticoagulation therapy is a cornerstone of stroke prevention in patients with AF [4]. Oral anticoagulants (OACs) are underprescribed, and many patients with AF or a history of stroke have not received appropriate anticoagulation therapy [6, 7]. Franchi C et al assessment of the appropriateness of prescribing OACs and their correlates in hospitalized patients over 65 years of age showed that nearly 44% of patients were inappropriately prescribed OACs [10]. The incidence of atrial fibrillation (AF) is increasing, and effective anticoagulation therapy can prevent adverse events. Interventions are going to be a potential area of focus
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
