Abstract
Background and aimWarfarin is recognized as a first-line treatment for different coagulopathy conditions; however, guidelines also encourage the use of rivaroxaban as an alternative option. The recent approval of the novel oral anticoagulants (NOACs) has led to swift changes in anticoagulant prescribing practices. This study aimed to review rivaroxaban prescribing patterns in adult patients in a large tertiary care setting in the Kingdom of Saudi Arabia (KSA).Materials and methodsA retrospective cross-sectional study was conducted from January 2019 to September 2020 at King Khalid University Hospital, Riyadh, KSA. Data was collected from the patient's medical record. Data analysis was performed with the Statistical Package for the Social Sciences (SPSS) IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.ResultsA total of 309 patients were included in this study. Rivaroxaban use for non-valvular atrial fibrillation (NVAF) was relatively higher than deep venous thrombosis/pulmonary embolism (DVT/PE). 45% of the patients had NVAF, followed by DVT/PE (26%), and DVT/PE prophylaxis (25%). Fifty-six patients, (18%) received an inappropriate dose of rivaroxaban for NVAF.ConclusionThis study found a relatively high percentage of inappropriate rivaroxaban prescribing, predominantly because of inappropriate dosing, which can potentially increase medication-related events. The use of rivaroxaban should be monitored to increase the appropriateness of therapy and improve patient safety.
Highlights
Anticoagulant therapy is the cornerstone of venous thromboembolism (VTE) treatment [1]
Rivaroxaban use for non-valvular atrial fibrillation (NVAF) was relatively higher than deep venous thrombosis/pulmonary embolism (DVT/PE). 45% of the patients had NVAF, followed by DVT/PE (26%), and DVT/PE prophylaxis (25%)
The use of rivaroxaban should be monitored to increase the appropriateness of therapy and improve patient safety
Summary
Anticoagulant therapy is the cornerstone of venous thromboembolism (VTE) treatment [1]. For more than 50 years, warfarin was the only available option as an oral anticoagulant (OAC) for the treatment of atrial fibrillation and other thrombotic conditions [2]. Novel oral anticoagulants (NOACs) or direct oral anticoagulants (DOACs) such as rivaroxaban, edoxaban, and apixaban are approved factor Xa inhibitors that provide anticoagulation via oral route [6]. These NOACs have expanded the options of OACs available to healthcare professionals. NOACs are attractive treatment options due to numerous challenges with warfarin therapy such as frequent monitoring, drug interactions, delayed time to onset, and a narrow therapeutic index [7]. This study aimed to review rivaroxaban prescribing patterns in adult patients in a large tertiary care setting in the Kingdom of Saudi Arabia (KSA)
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