What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Atrial fibrillation (n=19196). Intervention: Direct-acting oral anticoagulants (DOACs). Primary outcome: Potential drug interactions (co-prescribing of interacting medications with DOACs) (p=< 0.001).

November 5, 2020Journal of Clinical Medicine19 citationsOpen Access

Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study

Q: What are the key findings of this study?

Co-prescribing of interacting medications with DOACs decreased slightly over a five-year period (P for trend < 0.001), though interactions with SSRIs/SNRIs remained relatively unchanged.

WBWoldesellassie M. BezabheUniversity of Tasmania LBLre BereznickiUniversity of Tasmania JRJan RadfordUniversity of Tasmania

Key Result

Co-prescribing of interacting medications with DOACs decreased slightly over a five-year period (P for trend < 0.001), though interactions with SSRIs/SNRIs remained relatively unchanged.

Study Design

Type

Cross-Sectional (n=19,196)

Multicenter

Yes

Structured PICO

What are the five-year trends in potential drug interactions with DOACs in patients with atrial fibrillation?

Population

Patients with atrial fibrillation (AF) and a recorded DOAC prescription in the Australian national general practice dataset, MedicineInsight. Sample size ranged from 5,333 in 2014 to 19,196 in 2018.

Intervention

Co-prescribing of interacting medications (e.g., SSRI/SNRI, NSAIDs, CCBs, amiodarone) with DOACs

Outcome

Rate of co-prescribing interacting medications with DOACs over a five-year periodsafety

While overall potential drug interactions with DOACs have slightly decreased, co-prescription with SSRIs/SNRIs remains common and requires increased prescriber awareness.

Main Result

p-value: p=< 0.001

Abstract

BACKGROUND: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsight, over a five-year period. METHODS: We performed five sequential cross-sectional analyses in patients with atrial fibrillation (AF) and a recorded DOAC prescription. Patients were defined as having a drug interaction if they had a recorded prescription of an interacting medication while they had had a recorded prescription of DOAC in the previous six months. The sample size for the cross-sectional analyses ranged from 5333 in 2014 to 19,196 in 2018. RESULTS: for trend < 0.001. During this period, the most frequent interacting class of medication recorded as having been prescribed with DOACs was selective serotonin/serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants, followed by non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs) and amiodarone. CONCLUSIONS: Overall, potential drug interactions with DOACs have decreased slightly over the last five years; however, the rate of possible interaction with SSRIs/SNRIs has remained relatively unchanged and warrants awareness-raising amongst prescribers.

问 AI

Bookmark

View Full Paper