scholarly journals Use of direct oral anticoagulants in the first year after market entry of edoxaban: A Danish nationwide drug utilization study

2017 ◽  
Vol 27 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Anton Pottegård ◽  
Erik L. Grove ◽  
Maja Hellfritzsch
Keyword(s):  
Drug Utilization ◽  
Market Entry ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
First Year ◽  
Drug Utilization Study

scholarly journals Proton-pump inhibitors among adults: a nationwide drug-utilization study

2018 ◽  
Vol 11 ◽  
pp. 175628481877794 ◽  
Author(s):  
Óskar Ö. Hálfdánarson ◽  
Anton Pottegård ◽  
Einar S. Björnsson ◽  
Sigrún H. Lund ◽  
Margret H. Ogmundsdottir ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Oral Anticoagulants ◽  
Population Based ◽  
Annual Incidence ◽  
Drug Utilization Study ◽  
Duration Of Treatment ◽  
Entire Study ◽  
Inflammatory Drugs

Background: The use of proton-pump inhibitors (PPIs) has grown worldwide, and there are concerns about increased unsubstantiated long-term use. The aim of the study was to describe the real-world use of PPIs over the past decade in an entire national population. Methods: This was a nationwide population-based drug-utilization study. Patterns of outpatient PPI use among adults in Iceland between 2003 and 2015 were investigated, including annual incidence and prevalence, duration of use, and dose of tablet used (lower versus higher), as well as the proportion of PPI use attributable to gastroprotection. Results: We observed 1,372,790 prescription fills over the entire study period, of which 95% were for higher-dose PPIs. Annual incidence remained stable across time (3.3–4.1 per 100 persons per year), while the annual prevalence increased from 8.5 per 100 persons to 15.5 per 100 persons. Prevalence increased with patient age and was higher among women than men. Duration of treatment increased with patients’ age (36% of users over 80 years remained on treatment after 1 year compared with 13% of users aged 19–39 years), and was longer among those initiating on a higher dose compared with a lower dose. The proportion of PPI users concurrently using nonsteroidal anti-inflammatory drugs decreased over the study period, while the proportion concurrently using acetylsalicylic acid, oral anticoagulants, or platelet inhibitors increased. Conclusions: In this nationwide study, a considerable increase in overall outpatient use of PPIs over a 13-year period was observed, particularly among older adults. Patients were increasingly treated for longer durations than recommended by clinical guidelines and mainly with higher doses.

Review of Direct Oral Anticoagulants and Guide for Effective Drug Utilization

2019 ◽  
Vol 19 (6) ◽  
pp. 525-539 ◽  
Author(s):  
Tigran Khachatryan ◽  
Christopher Hauschild ◽  
Jason Hoff ◽  
Tahmeed Contractor ◽  
Arthur Khachatryan ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Effective Drug

scholarly journals Adherence to Direct Oral Anticoagulants in Patients With Non-Valvular Atrial Fibrillation: A Cross-National Comparison in Six European Countries (2008–2015)

2021 ◽  
Vol 12 ◽  
Author(s):  
M. Sabaté ◽  
X. Vidal ◽  
E. Ballarin ◽  
M. Rottenkolber ◽  
S. Schmiedl ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Switching Rate ◽  
Drug Utilization Study ◽  
Persistence Rate ◽  
National Comparison ◽  
Data Source ◽  
Baseline Characteristics ◽  
Cross National

Aims: To describe and compare the adherence to different direct oral anticoagulants (DOACs) in eight European databases representing six countries.Methods: Longitudinal drug utilization study of new users (≥18 years) of DOACs (dabigatran, rivaroxaban, apixaban) with a diagnosis of non-valvular atrial fibrillation (2008–2015). Adherence was examined by estimating persistence, switching, and discontinuation rates at 12 months. Primary non-adherence was estimated in BIFAP and SIDIAP databases.Results: The highest persistence rate was seen for apixaban in the CPRD database (81%) and the lowest for dabigatran in the Mondriaan database (22%). The switching rate for all DOACs ranged from 2.4 to 13.1% (Mondriaan and EGB databases, respectively). Dabigatran had the highest switching rate from 5.0 to 20.0% (Mondriaan and EGB databases, respectively). The discontinuation rate for all DOACs ranged from 16.0 to 63.9% (CPRD and Bavarian CD databases, respectively). Dabigatran had the highest rate of discontinuers, except in the Bavarian CD and AOK NORDWEST databases, ranging from 23.2 to 64.6% (CPRD and Mondriaan databases, respectively). Combined primary non-adherence for examined DOACs was 11.1% in BIFAP and 14.0% in SIDIAP. There were differences in population coverage and in the type of drug data source among the databases.Conclusion: Despite the differences in the characteristics of the databases and in demographic and baseline characteristics of the included population that could explain some of the observed discrepancies, we can observe a similar pattern throughout the databases. Apixaban was the DOAC with the highest persistence. Dabigatran had the highest proportion of discontinuers and switchers at 12 months in most databases (EMA/2015/27/PH).

Implementation of a Direct Oral Anticoagulation Screening Service at a Large Academic Medical Center Provided by a Pharmacist-managed Antithrombosis Clinic as a Method to Expand Antithrombotic Stewardship Efforts

2018 ◽  
Vol 33 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Ellen M. Uppuluri ◽  
Meghan N. McComb ◽  
Nancy L. Shapiro
Keyword(s):  
Medical Center ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Academic Medical Center ◽  
Electronic Prescribing ◽  
First Year ◽  
Screening Service ◽  
Medication Access ◽  
Academic Medical

Background: How and when to monitor direct oral anticoagulants (DOACs) for safety and efficacy is a question many anticoagulation clinics are trying to answer. A pharmacist-led antithrombosis clinic (ATC) initiated a clinical service to provide oversight for all prescribed DOACs. Objective: Describe the implementation and outcomes of a DOAC screening service. Methods: The service was initiated utilizing a daily electronic prescribing report of DOAC prescriptions. Prescriptions were reviewed by clinical pharmacists to assess patient insurance, eligibility, and accuracy of prescribed doses. Results: In the first year since service implementation in April 2016, 317 new prescriptions and 595 refill prescriptions were reviewed. A DOAC service pharmacist was able to reach 125 (39.4%) of 317 patients about their new prescription and 59 (9.9%) of 595 refill patients to provide education and follow-up on management as needed. Interventions were performed for 79 (28%) of 317 new prescriptions and 86 (14.5%) of 595 refill prescriptions. Common interventions with new prescriptions include contacting the prescriber for a medication or dose change (25.4%), assistance with medication access (21.5%), and coordinating appropriate lab and provider follow up (21.5%). Common interventions with refill prescriptions include recommending appropriate follow-up (50%) and contacting the prescriber for medication or dosage change (24.4%). Conclusion: Implementation of a DOAC screening service identified and resolved dosing errors, improved medication access, provided patient education, and improved follow-up.

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