Key result
This narrative review highlights the high prevalence of inappropriate DOAC prescribing in hospitalized patients and emphasizes the need for anticoagulant stewardship programs to optimize dosing.
Why the study?
DOAC prescriptions are commonly inconsistent with guideline recommendations, and DOAC dosing in acutely ill hospitalized patients poses a significant challenge.
What is the prevalence, predictors, and clinical consequences of inappropriate DOAC prescribing in hospitalized patients?
What is the prevalence, predictors, and clinical consequences of inappropriate DOAC prescribing in hospitalized patients?
This review highlights the high prevalence of inappropriate DOAC dosing in hospitalized patients and advocates for anticoagulant stewardship programs to optimize treatment.
Inappropriate inpatient DOAC dosing remains prevalent; leaves open whether targeted interventions improve guideline adherence in acutely ill patients.
Direct oral anticoagulants (DOACs) have become the cornerstone for prevention of thromboembolic events in patients with atrial fibrillation and patients with a history of venous thromboembolism. However, studies show that DOAC prescriptions are commonly inconsistent with guideline recommendations. DOAC dosing in the acutely ill patient could impose an even greater challenge. In this review, we describe the prevalence of inappropriate inpatient prescribing of DOACs and the associated rationales, predictors and clinical consequences. With the aim of promoting appropriate prescriptions of DOACs to hospitalized patients, we further outline DOAC dose reduction criteria justified by various guidelines, illustrating the complexities of appropriate dosing, especially in acutely ill patients. Moreover, we will discuss the impact of anticoagulant stewardship programs and the vital role that pharmacists may play in optimizing inpatient DOAC treatment.
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Horst et al. (2023) conducted a review in Atrial fibrillation and venous thromboembolism in hospitalized patients. Direct oral anticoagulants (DOACs) was evaluated. This narrative review highlights the high prevalence of inappropriate DOAC prescribing in hospitalized patients and emphasizes the need for anticoagulant stewardship programs to optimize dosing.
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