Advantages of Rivaroxaban as an Anticoagulant: Strategies for Effective Use and Adverse Effect Management in Tertiary Care Hospitals

Background: Anticoagulants are the cornerstone therapy for thromboembolism prevention and treatment. Rivaroxabanis the an oral anticoagulant drug .It needs high-quality anticoagulation monitoring with frequent international normalization ratio (INR) testing. Objective: The study aimed to assess anticoagulation management with Rivaroxaban among adult outpatients and acess its adverse effect management produced in the tertiary care hospital . Methods: A hospital-based retrospective study design that enrolled 374 patients receiving Rivaroxaban was taken in the study conducted at two centres i.e,Jinnah Postgraduate medical centre and Abbasi shaheed hospital. The time in the therapeutic range (TTR) was calculated using the Rosendaal method. Results: The mean age of the patients was 57 years, and 218 (58.3%) participants were females. Out of 3384 INR tests, 1562 (46.5%) were within the therapeutic range and the mean percentage of TTR was 47.24%. Only 25.67% of the patients spent their TTR ≥ 65%. The present study revealed that dose adjustments were required 1764 times. In non-therapeutic INR values of 1764 that required Rivaroxaban dose adjustment, 59.7% of the doses were adjusted. About 262 (70.1%) of co-prescribed medications had drug interaction . Sixty-four patients (17.11%) experienced bleeding events. Conclusion: Anticoagulation management with Rivaroxaban was suboptimal .INR values was not minimal, and many patients encountered bleeding during their course of therapy.