PMID- 28188509
OWN - NLM
STAT- MEDLINE
DCOM- 20170822
LR  - 20181113
IS  - 2210-7711 (Electronic)
VI  - 39
IP  - 2
DP  - 2017 Apr
TI  - Anticoagulation in atrial fibrillation: NOAC prescribing in primary health care.
PG  - 478-482
LID - 10.1007/s11096-017-0431-9 [doi]
AB  - Background Few studies assess the use of non-vitamin K antagonist oral 
      anticoagulants (NOACs) in daily practice for the prevention of thromboembolic 
      complications associated to nonvalvular atrial fibrillation (AF). Objectives 
      Describe NOACs' use and analyze its prescribing pattern. Evaluate possible 
      factors associated to adverse events (AEs) and the applicability of prescription 
      support forms. Methods We included patients with AF treated with a NOAC during 
      2014 in three primary healthcare centers in Barcelona, Spain. Demographic and 
      clinical data was collected, as well as embolic and bleeding risk and reported 
      AEs. Results A total of 101 patients were included, with a median age of 
      75 years. The NOACs most frequently prescribed were dabigatran and rivaroxaban. 
      An 87.2% of the patients were receiving the recommended dosage. A potential 
      bleeding risk was present in 47% of the subjects. Ten AEs were reported, of which 
      eight hemorrhages. Patients who presented an AE were >65 years and had a higher 
      proportion of concomitant treatment and/or co-morbidities that could prompt to 
      bleeding (p < 0.001). Conclusions Current treatment practice is according to 
      regulatory agencies' recommendations. Close monitoring is especially needed in 
      patients >65 years and at higher risk of bleeding. Prescription support forms 
      help good prescribing and identifying potential individuals at high risk of AEs.
FAU - Bastida, Carla
AU  - Bastida C
AD  - Pharmacy Department, Hospital Clinic, Barcelona, Spain. cbastida@clinic.ub.es.
FAU - Corominas, Nuria
AU  - Corominas N
AD  - Pharmacy Department, Hospital Clinic, Barcelona, Spain.
FAU - Sotoca, Jose Miguel
AU  - Sotoca JM
AD  - Pharmacy Department, Hospital Clinic, Barcelona, Spain.
FAU - Rovira, Marina
AU  - Rovira M
AD  - Pharmacy Department, Hospital Clinic, Barcelona, Spain.
AD  - Grup Transversal de Recerca en Atencio Primaria, IDIBAPS, Barcelona, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170210
PL  - Netherlands
TA  - Int J Clin Pharm
JT  - International journal of clinical pharmacy
JID - 101554912
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*adverse effects/therapeutic use
MH  - Atrial Fibrillation/*drug therapy
MH  - Female
MH  - Hemorrhage/chemically induced/*epidemiology
MH  - Humans
MH  - Male
MH  - Practice Patterns, Physicians'
MH  - Primary Health Care/*statistics & numerical data
MH  - Risk Factors
MH  - Spain/epidemiology
MH  - Thromboembolism/*prevention & control
OTO - NOTNLM
OT  - Adverse events
OT  - Anticoagulants
OT  - Atrial fibrillation
OT  - Drug utilization
OT  - Primary health care
OT  - Spain
EDAT- 2017/02/12 06:00
MHDA- 2017/08/23 06:00
CRDT- 2017/02/12 06:00
PHST- 2016/07/13 00:00 [received]
PHST- 2017/01/24 00:00 [accepted]
PHST- 2017/02/12 06:00 [pubmed]
PHST- 2017/08/23 06:00 [medline]
PHST- 2017/02/12 06:00 [entrez]
AID - 10.1007/s11096-017-0431-9 [pii]
AID - 10.1007/s11096-017-0431-9 [doi]
PST - ppublish
SO  - Int J Clin Pharm. 2017 Apr;39(2):478-482. doi: 10.1007/s11096-017-0431-9. Epub 
      2017 Feb 10.