Evaluation of oral anticoagulant prescribing patterns and associated hospital acquired complications – a single centre Australian study

Background Oral Anticoagulants (OACs) are widely prescribed for various chronic conditions. Inappropriate prescribing has been reported in various settings. Aims The primary aim of this study was to assess the proportion of inpatients who were prescribed OACs concordant with prescribing recommendations. The secondary aims were to assess predictors of inappropriate prescribing and evaluate the number of related hospital‐acquired complications (HAC). Method A retrospective audit was conducted in a multisite 650‐bed Australian Hospital from January to March 2019 to fulfil the study objectives. Consecutive patients who were discharged on OAC were included. Patients’ demographics, OAC prescribed and comorbidities data were collected. Appropriateness of OAC use was evaluated according to the manufacturer’s recommendations. HAC data were retrieved from the hospital coding unit from January to June 2019 to evaluate the impact of inappropriate OAC prescribing. Results A total of 322 patients were eligible to be included in the study. Of this cohort, 185 (57%) were prescribed appropriate therapy. There was a total of 78 HAC reported cases over the study period. Predictors of inappropriate prescribing included those with HASBLED scores > 3 (OR = 0.205 (0.127–0.331), p < 0.0001), discharged from surgical units (OR = 0.522 (0.312–0.875), p = 0.014) or prescribed warfarin (OR = 0.236 (0.106–0.524), p < 0.001). [Correction added on 19 April 2022: “CHA2DS2‐VASc > 3 (OR = 0.668 (0.426–1.049), p = 0.079),” was removed from before “HASBLED scores > 3…” in the preceding sentence.] Conclusion Inappropriate OAC prescribing is prevalent among inpatients. Strategies should be developed to assist clinicians to improve OAC prescribing in an evidence‐based approach.