dc.contributor.author |
Wattanaruengchai P. |
|
dc.contributor.author |
Nathisuwan S. |
|
dc.contributor.author |
Rattanavipanon W. |
|
dc.contributor.author |
Chulavatnatol S. |
|
dc.contributor.author |
Kongwatcharapong J. |
|
dc.contributor.author |
Mitsuntisuk P. |
|
dc.contributor.author |
Chaiyasothi T. |
|
dc.contributor.author |
Kritsanapipat D. |
|
dc.contributor.author |
Phrommintikul A. |
|
dc.contributor.author |
Chaiyakunapruk N. |
|
dc.contributor.author |
Likittanasombat K. |
|
dc.contributor.author |
Lip G.Y.H. |
|
dc.date.accessioned |
2022-03-10T13:16:55Z |
|
dc.date.available |
2022-03-10T13:16:55Z |
|
dc.date.issued |
2021 |
|
dc.identifier.issn |
3065251 |
|
dc.identifier.other |
2-s2.0-85090448785 |
|
dc.identifier.uri |
https://ir.swu.ac.th/jspui/handle/123456789/17346 |
|
dc.identifier.uri |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85090448785&doi=10.1111%2fbcp.14535&partnerID=40&md5=dd2cfce96a4da9b8618c751193ea4fd6 |
|
dc.description.abstract |
Aims: This study aimed to evaluate the prescriber compliance to the approved labels of direct oral anticoagulants (DOACs) and impact of appropriateness of dosing on clinical outcomes. Methods: A retrospective study was conducted using simple-stratified random sampling of adult patients receiving ≥6 months of DOACs for various indications during 2013–2017 in 10 tertiary care hospitals. Patients were classified into 3 dosing groups including approved dose, underdosing and overdosing based on the Thai Food and Drug Administration-approved labels. Cox proportional hazard models were used to evaluate the impact of different dosings on thromboembolic and bleeding events. Results: From 1200 patients included in the data analysis, prescribing of DOACs was consistent with the approved indications in 1130 cases (94.2%) while 70 patients (5.8%) received DOACs despite having contraindications or with off-label usage. Among 1026 cases of dosing evaluation cohort, 688 patients (67.1%) received approved doses. There were 227 (21.9%) and 110 (10.7%) cases of underdosing and overdosing, respectively. Multivariate analysis showed that underdosing was associated with an increased risk of thromboembolism 3.023 (95% confidence interval [CI]: 1.291–7.080; P =.011) while overdosing was associated with an increased risk of bleeding requiring hospitalization (adjusted hazard ratio, 3.045; 95% CI, 1.501–6.178; P =.002) and Bleeding Academic Research Consortium type 2 or more (adjusted hazard ratio, 2.196; 95% CI, 1.083–4.452; P =.029). Conclusion: Prescribers’ compliance to approved indications were high. However, 1/3 of DOAC prescriptions were inconsistent with approved dosing. Dosing deviation was associated with an increase in adverse clinical outcomes. © 2020 The British Pharmacological Society |
|
dc.language |
en |
|
dc.subject |
antithrombocytic agent |
|
dc.subject |
apixaban |
|
dc.subject |
beta adrenergic receptor blocking agent |
|
dc.subject |
dabigatran |
|
dc.subject |
dipeptidyl carboxypeptidase inhibitor |
|
dc.subject |
hydroxymethylglutaryl coenzyme A reductase inhibitor |
|
dc.subject |
rivaroxaban |
|
dc.subject |
warfarin |
|
dc.subject |
anticoagulant agent |
|
dc.subject |
aged |
|
dc.subject |
Article |
|
dc.subject |
atrial fibrillation |
|
dc.subject |
cerebrovascular accident |
|
dc.subject |
clinical outcome |
|
dc.subject |
cohort analysis |
|
dc.subject |
controlled study |
|
dc.subject |
deep vein thrombosis |
|
dc.subject |
embolism |
|
dc.subject |
female |
|
dc.subject |
follow up |
|
dc.subject |
Food and Drug Administration |
|
dc.subject |
human |
|
dc.subject |
human tissue |
|
dc.subject |
lung embolism |
|
dc.subject |
major clinical study |
|
dc.subject |
male |
|
dc.subject |
medication compliance |
|
dc.subject |
multicenter study (topic) |
|
dc.subject |
patient compliance |
|
dc.subject |
prescription |
|
dc.subject |
priority journal |
|
dc.subject |
retrospective study |
|
dc.subject |
tertiary care center |
|
dc.subject |
Thailand |
|
dc.subject |
thromboembolism |
|
dc.subject |
university hospital |
|
dc.subject |
adult |
|
dc.subject |
atrial fibrillation |
|
dc.subject |
oral drug administration |
|
dc.subject |
Administration, Oral |
|
dc.subject |
Adult |
|
dc.subject |
Anticoagulants |
|
dc.subject |
Atrial Fibrillation |
|
dc.subject |
Humans |
|
dc.subject |
Retrospective Studies |
|
dc.subject |
Thailand |
|
dc.title |
Prescriber compliance to direct oral anticoagulant labels and impact on outcomes in Thailand |
|
dc.type |
Article |
|
dc.rights.holder |
Scopus |
|
dc.identifier.bibliograpycitation |
British Journal of Clinical Pharmacology. Vol 87, No.3 (2021), p.1390-1400 |
|
dc.identifier.doi |
10.1111/bcp.14535 |
|