Atrial fibrillation (AF) is a common cardiovascular disease for which newer oral anticoagulants are available. The main objective of this study was to evaluate the appropriateness in prescriptions of direct oral anticoagulant (DOACs), more specifically apixaban, dabigatran and rivaroxaban. This was a singlecentre, retrospective study conducted in the province of Quebec, Canada. Adult subjects hospitalized between October 2011 and October 2014, with a diagnosis of AF, and a DOAC prescription were included. Data were retrieved from the electronic medical records and prescriptions were evaluated according to appropriateness criteria. A total of 500 subjects were included (235 subjects on dabigatran,222 on rivaroxaban and 43 on apixaban). Overall, 70.4% (95% confidence interval [Cl] 66.4-74.1) of DOAC prescriptions were considered appropriate. About 24% of subjects received an inappropriate dose of apixaban, dabigatran or rivaroxaban. A reduced dose was prescribed in 56.8% of subjects with no clearindication, and 43.2% received a dose that was not reduced while indicated. DOACs were frequentlyprescribed at a dose that was considered inappropriate. There is a need to strengthen dosing recommendations of DOACs in clinical practice.

PASE score), exhaustion (CES-D questionnaire) and shrinking (self-reported unintentional weight loss). Frailty is diagnosed when a patient scores below the pre-specified cutoff in >3 of the 5 domains. Follow up assessments will be performed at 1, 6, 12, and 24 months with all-cause mortality as the primary endpoint. Appropriate and inappropriate ICD therapies, and hospitalizations are secondary endpoints. RESULTS: We report on 19 patients who were referred for ICD/CRT insertion for primary prevention. Mean age was 71 AE 5.9 years and fifteen were male. The majority of patients had ischemic cardiomyopathy (n¼12). Overall, 13 patients received an ICD, 3 received CRT-D, and 3 patients declined device insertion. Of note, none of the 3 patients declining a device were diagnosed as frail. Frailty was diagnosed in 3 patients, representing a prevalence of 15%. Domain-specific results of frailty assessment appear in Table 1. CONCLUSION: The prevalence of frailty among patients referred for a primary prevention ICD/CRT is comparable to that of the community-dwelling elderly population. The impact of frailty on outcomes in these patients is yet to be determined.