Details

Autor(en) / Beteiligte

• van der Horst, S.F.B.
• van Rein, N.
• van Mens, T.E.
• Huisman, M.V.
• Klok, F.A.

Titel

Inappropriate prescriptions of direct oral anticoagulants (DOACs) in hospitalized patients: A narrative review

Ist Teil von

• Thrombosis research, 2023-11, Vol.231, p.135-140

Ort / Verlag

United States: Elsevier Ltd

Erscheinungsjahr

2023

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Direct oral anticoagulants (DOACs) have become the cornerstone for prevention of thromboembolic events in patients with atrial fibrillation and patients with a history of venous thromboembolism. However, studies show that DOAC prescriptions are commonly inconsistent with guideline recommendations. DOAC dosing in the acutely ill patient could impose an even greater challenge. In this review, we describe the prevalence of inappropriate inpatient prescribing of DOACs and the associated rationales, predictors and clinical consequences. With the aim of promoting appropriate prescriptions of DOACs to hospitalized patients, we further outline DOAC dose reduction criteria justified by various guidelines, illustrating the complexities of appropriate dosing, especially in acutely ill patients. Moreover, we will discuss the impact of anticoagulant stewardship programs and the vital role that pharmacists may play in optimizing inpatient DOAC treatment. [Display omitted] •Inhospital DOAC prescriptions are commonly inconsistent with recommendations.•DOAC dose reduction criteria are relatively complex.•Pharmacists may play a vital role in optimizing inhospital DOAC prescriptions.•Clinical consequences of inappropriate inhospital DOAC dosing are unknown.