Safe implementation of new oral anticoagulants requires optimization of dose adjustment based on therapeutic drug levels and the implementation of procedures to improve medication adherence.
New oral anticoagulants (NOACs) have been introduced to improve anticoagulant therapy worldwide, but safe implementation may require additional measures. First, optimization of dose adjustment based on therapeutic levels of the drug may be more appropriate than fixed dose therapy. The development and implementation in quantitative laboratory assays will enable further dose optimization. Second, non-adherence to medication is a potential threat to the safe use of NOACs. Since cardiovascular medication may not be optimally used in about 50% of patients, procedures to improve adherence are imperative, also for NOAC therapy and in particular in elderly patients.
Hugo Ten Cate (2013) conducted an editorial in Thrombotic disorders. New oral anticoagulants (NOACs) vs. Vitamin K antagonists (VKA) was evaluated. Safe implementation of new oral anticoagulants requires optimization of dose adjustment based on therapeutic drug levels and the implementation of procedures to improve medication adherence.