Trends in Prescription of Novel Oral Anticoagulants (NOACs) and Warfarin in Australia 2010-2015

Castles, A. Vlachadis; Tsay, I.; Gaal, W. van

doi:10.1016/j.hlc.2016.06.322

Cited by 3 publications

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“…Use of direct oral anticoagulants (DOACs) is constantly increasing. 1 Indications for use include treatment and prophylaxis of deep vein thrombosis or pulmonary embolism and prevention of systemic embolization in non-valvular atrial fibrillation. 2 DOACs provide a stable pharmacokinetic profile and do not require routine drug monitoring, directly addressing shortcomings in managing Warfarin.…”

Section: Introductionmentioning

confidence: 99%

Early Surgical Fixation for Hip Fractures in Patients Taking Direct Oral Anticoagulation: A Retrospective Cohort Study

King

Polischuk

Lynch

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: Currently, evidence-based guidelines regarding delay to theatre for urgent surgical intervention in patients taking direct oral anticoagulants (DOACs) are lacking. Therefore, this study aims to investigate the effect of DOACs on patient outcomes receiving early (<48 hours) versus delayed (>48 hours) surgery for neck of femur fractures. Methods: A retrospective cohort study was conducted at a tertiary teaching hospital. Treatment groups were hip fracture patients taking DOACs on admission and receiving surgery in <48 hours (n = 17) and >48 hours (n = 11). A control cohort of hip fracture patients not taking DOACs (n = 56) was matched to the <48 hours treatment group for comparison. Patient demographics were recorded and key outcome measures included perioperative hemoglobin levels, transfusion rates, time to surgery, 90-day mortality, hematoma rates, and length of stay in hospital. Results: There was no significant difference in perioperative hemoglobin levels, transfusion rates, or hematoma between groups. Patients taking DOACs and receiving early surgery had significantly longer time to surgery compared to the non-DOAC control (32.21 ± 7.83 vs 25.98 ± 11.4, P = .01). No deaths were recorded in the early DOAC group at 90 days, compared to 4 (36%) in the late DOAC group ( P = .04). Discussion and Conclusions: Our study suggests hip fracture patients taking DOACs on admission is not a reason to delay surgery. However, given the lack of literature in this area, further prospective research with larger patient numbers is required to definitively guide clinical practice.

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Section: Introductionmentioning

confidence: 99%

Early Surgical Fixation for Hip Fractures in Patients Taking Direct Oral Anticoagulation: A Retrospective Cohort Study

King

Polischuk

Lynch

et al. 2020

Geriatr Orthop Surg Rehabil

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Types and causes of anticoagulant‐related medication incidents across hospitals in Western Australia

Jovanovska

Fitzsimons

Ferguson

et al. 2019

Pharmacy Practice and Res

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BackgroundAnticoagulant medications are widely prescribed for the treatment and prevention of thromboembolic disorders. They are considered high‐risk medications due to their narrow therapeutic window and potential to cause serious fatal haemorrhagic or thromboembolic complications.AimThis study analysed all reported medication safety incidents related to anticoagulants across Western Australian (WA) public hospitals over a 12‐month period to determine possible causative factors.MethodsA mixed‐methods study of all reported anticoagulant‐related medication incidents between 1 July 2016 and 30 June 2017 across 93 WA public hospitals was conducted. The study identified the confirmed level of harm that occurred to patients, the phase during the medication management cycle when the incident occurred, the incident type and causative factors.ResultsSix per cent (n = 417) of all medication‐related clinical incidents reported during the study period involved anticoagulants, of which 0.2% caused significant harm and 6.7% caused moderate harm. Most incidents occurred during the administration phase (69.1%). The most frequent incident type reported was omission of dose (29.5%) and the most frequent causative factors reported were inadequate checking process (20.7%; n = 746) and inadequate documentation (18.8%).ConclusionMost anticoagulant incidents occurred during the administration phase, with inadequate checking processes and incomplete or illegible documentation being the most frequently reported causative factors. Review of direct oral anticoagulant‐reported incidents identified staff knowledge deficits with regard to indication‐based dosing and dose modification requirements in renal impairment. These findings contributed towards development of targeted strategies and education resources to reduce the incidence of anticoagulant‐related medication incidents.

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Safety of direct oral anticoagulants in real–world clinical practice: translating the trials to everyday clinical management

Fawzy

Yang

Lip

2019

Expert Opinion on Drug Safety

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Trends in Prescription of Novel Oral Anticoagulants (NOACs) and Warfarin in Australia 2010-2015

Cited by 3 publications

References 0 publications

Early Surgical Fixation for Hip Fractures in Patients Taking Direct Oral Anticoagulation: A Retrospective Cohort Study

Early Surgical Fixation for Hip Fractures in Patients Taking Direct Oral Anticoagulation: A Retrospective Cohort Study

Types and causes of anticoagulant‐related medication incidents across hospitals in Western Australia

Safety of direct oral anticoagulants in real–world clinical practice: translating the trials to everyday clinical management

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