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Five-year trends in potential drug interactions with direct-acting oral anticoagulants in patients with atrial fibrillation: an Australian-wide study


Bezabhe, WM and Bereznicki, LR and Radford, J and Wimmer, BC and Salahudeen, MS and Bindoff, I and Garrahy, E and Peterson, GM, Five-year trends in potential drug interactions with direct-acting oral anticoagulants in patients with atrial fibrillation: an Australian-wide study, Journal of Clinical Medicine, 9, (11) Article 3568. ISSN 2077-0383 (2020) [Refereed Article]


Copyright Statement

Copyright 2020 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.3390/jcm9113568


Background: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsight, over a five-year period.

Methods: We performed five sequential cross-sectional analyses in patients with atrial fibrillation (AF) and a recorded DOAC prescription. Patients were defined as having a drug interaction if they had a recorded prescription of an interacting medication while they had had a recorded prescription of DOAC in the previous six months. The sample size for the cross-sectional analyses ranged from 5333 in 2014 to 19,196 in 2018.

Results: The proportion of patients who had potential drug interactions with a DOAC decreased from 45.9% (95% confidence interval (CI) 44.6%–47.4%) in 2014 to 39.9% (95% CI 39.2%–40.6%) in 2018, p for trend < 0.001. During this period, the most frequent interacting class of medication recorded as having been prescribed with DOACs was selective serotonin/serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants, followed by non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs) and amiodarone.

Conclusions: Overall, potential drug interactions with DOACs have decreased slightly over the last five years; however, the rate of possible interaction with SSRIs/SNRIs has remained relatively unchanged and warrants awareness-raising amongst prescribers.

Item Details

Item Type:Refereed Article
Keywords:atrial fibrillation, direct-acting oral anticoagulants, drug–drug interactions, primary care
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacology and therapeutics
Objective Division:Health
Objective Group:Other health
Objective Field:Other health not elsewhere classified
UTAS Author:Bezabhe, WM (Dr Woldesellassie Bezabhe)
UTAS Author:Bereznicki, LR (Professor Luke Bereznicki)
UTAS Author:Radford, J (Professor Jan Radford)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
UTAS Author:Salahudeen, MS (Dr Mohammed Salahudeen)
UTAS Author:Bindoff, I (Dr Ivan Bindoff)
UTAS Author:Garrahy, E (Dr Edward Garrahy)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
ID Code:141675
Year Published:2020
Web of Science® Times Cited:7
Deposited By:Pharmacy
Deposited On:2020-11-09
Last Modified:2021-03-11
Downloads:21 View Download Statistics

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