Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Extract

The introduction of direct-acting oral anticoagulants (DOACs) to the market in 2010 changed the landscape of anticoagulation management.1 Despite their known advantages over warfarin, DOACs have patient-specific and indication-specific dosing requirements and therefore pose a risk of prescribing errors. A study by Sanghai et al2 showed that 24% of geriatric patients on DOAC therapy for atrial fibrillation (AF) had inappropriately dosing. In a separate prospective cohort study, a third of patients were prescribed an off-label reduced dose of DOAC therapy.3

Both underdosing and overdosing of DOAC therapies may result in negative outcomes. Multiple published studies have demonstrated an association between underdosing of DOACs and an increased risk of stroke, systemic embolism, and all-cause mortality.4-6 Overdosing of DOAC agents has been associated with an increased risk of stroke and systemic embolism as well as major bleed rates and all-cause mortality.4-6 In 2019, due to the increasing incidence of adverse drug events, DOACs were incorporated into The Joint Commission (TJC) National Patient Safety Goal (NPSG) for anticoagulation therapy.7,8 The opportunities for quality improvement noted above led to a postgraduate year 2 (PGY2) residency project aimed at exploring potential pharmacist impact on outpatient DOAC prescribing at Nebraska Medicine (NM). For this paper, outpatient prescribing refers to prescriptions generated from any clinic or ambulatory setting, as well as emergency department (ED) and hospital discharges.

Issue Section:
Frontline Pharmacist
You do not currently have access to this article.
Download all slides

Comments

0 Comments
Comments (0)
Submit a comment
You have entered an invalid code
Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email.