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Suboptimal use of oral anticoagulants in atrial fibrillation: has the introduction of direct oral anticoagulants improved prescribing practices?

Citation

Alamneh, EA and Chalmers, L and Bereznicki, LR, Suboptimal use of oral anticoagulants in atrial fibrillation: has the introduction of direct oral anticoagulants improved prescribing practices?, American Journal of Cardiovascular Drugs, 16, (3) pp. 183-200. ISSN 1175-3277 (2016) [Refereed Article]

Copyright Statement

Copyright Springer International Publishing Switzerland 2016

DOI: doi:10.1007/s40256-016-0161-8

Abstract

Background and Objectives: Atrial fibrillation (AF) and the associated risk of stroke are emerging epidemics throughout the world. Suboptimal use of oral anticoagulants for stroke prevention has been widely reported from observational studies. In recent years, direct oral anticoagulants (DOACs) have been introduced for thromboprophylaxis. We conducted a systematic literature review to evaluate current practices of anticoagulation in AF, pharmacologic features and adoption patterns of DOACs, their impacts on proportion of eligible patients with AF who receive oral anticoagulants, persisting challenges and future prospects for optimal anticoagulation.

Literature Source and Selection Criteria: In conducting this review, we considered the results of relevant prospective and retrospective observational studies from real-world practice settings. PubMed (MEDLINE), Scopus (RIS), Google Scholar, EMBASE and Web of Science were used to source relevant literature. There were no date limitations, while language was limited to English. Selection was limited to articles from peer reviewed journals and related to our topic.

Results: Most studies identified in this review indicated suboptimal use of anticoagulants is a persisting challenge despite the availability of DOACs. Underuse of oral anticoagulants is apparent particularly in patients with a high risk of stroke. DOAC adoption trends are quite variable, with slow integration into clinical practice reported in most countries; there has been limited impact to date on prescribing practice.

Conclusion: Available data from clinical practice suggest that suboptimal oral anticoagulant use in patients with AF and poor compliance with guidelines still remain commonplace despite transition to a new era of anticoagulation featuring DOACs.

Item Details

Item Type:Refereed Article
Keywords:atrial fibrillation, elderly, anticoagulants
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacy and Pharmacy Practice
Objective Division:Health
Objective Group:Other Health
Objective Field:Health not elsewhere classified
Author:Alamneh, EA (Mr Endalkachew Alamneh)
Author:Chalmers, L (Dr Leanne Chalmers)
Author:Bereznicki, LR (Associate Professor Luke Bereznicki)
ID Code:106755
Year Published:2016
Web of Science® Times Cited:9
Deposited By:Pharmacy
Deposited On:2016-02-19
Last Modified:2017-11-02
Downloads:0

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