Changes in anticoagulant prescription in a general hospital in 2008-2018
Open Access
- 3 September 2021
- journal article
- research article
- Published by Silicea - Poligraf in Rational Pharmacotherapy in Cardiology
- Vol. 17 (4), 544-551
- https://doi.org/10.20996/1819-6446-2021-08-10
Abstract
Aim. To study the structure of anticoagulant prescription in a general hospital to identify trends and contributing factors. Materials and methods. The study was conducted in an urban general hospital. According to retrospective retrieval from electronic health records, total 17,129 patients received anticoagulants from 2008 to 2018. Formal appropriateness of oral anticoagulants (OАС) prescriptions for 6,638 patients with atrial fibrillation (AF) was analyzed with CHA2-DS2-VASc score. Results. Appearance of recommendations for the direct oral anticoagulants (DOAC) prescription in clinical guidelines for venous thromboembolism (VTE) and AF management contributed to steady increase in the DOAC taking and decrease in the proportion of warfarin prescription. From 2011 to 2018, the proportion of patients with DOACs prescription increased from 1.7% to 81.5%. The most common indications for anticoagulant were ischemic stroke prevention in AF and VTE with mean rate 75.3% and 23.2%, respectively for the 2011-2018 period. Steady increase in low-molecular-weight heparin (LMWH) prophylactic prescriptions was also shown (Chi-square for linear trend=1340, df=1, pConclusion. The study showed that in a general hospital anticoagulants were prescribed in 19% of hospitalized patient. Not only the new clinical recommendations based on the results of the recent studies on anticoagulants efficacy and safety (external factors), but also implementation standard operating protocols and CDSS, providing physicians current information about the relevant clinical recommendations (internal changes), could influence the appropriateness of anticoagulants prescription.Keywords
This publication has 19 references indexed in Scilit:
- Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical PatientsThe New England Journal of Medicine, 2013
- 2012 focused update of the ESC Guidelines for the management of atrial fibrillationEuropean Heart Journal, 2012
- Antithrombotic Therapy for VTE Disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice GuidelinesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2012
- The answer is 17 years, what is the question: understanding time lags in translational researchJournal of the Royal Society of Medicine, 2011
- Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)European Heart Journal, 2010
- Diffusion Theory and Knowledge Dissemination, Utilization, and Integration in Public HealthAnnual Review of Public Health, 2009
- Thrombolysis during cardiopulmonary resuscitation should be addressed in guidelines for pulmonary embolism: replyEuropean Heart Journal, 2008
- Guidelines on the diagnosis and management of acute pulmonary embolismEuropean Heart Journal, 2008
- Practice-Based Research—“Blue Highways” on the NIH RoadmapJAMA, 2007
- ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation—Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm SocietyJournal of Invasive Cardiology, 2006