| Title |
Is the prescription right? A review of non-vitamin K antagonist anticoagulant (NOAC) prescriptions in patients with non-valvular atrial fibrillation. Safe prescribing in atrial fibrillation and evaluation of non-vitamin K oral anticoagulants in stroke prevention (SAFE-NOACS) group
|
|---|---|
| Published in |
Irish Journal of Medical Science, June 2018
|
| DOI | 10.1007/s11845-018-1837-7 |
| Pubmed ID | |
| Authors |
Rebabonye B. Pharithi, Deepti Ranganathan, Jim O’Brien, Emmanuel E. Egom, Cathie Burke, Daniel Ryan, Christine McAuliffe, Marguerite Vaughan, Tara Coughlan, Edwina Morrissey, John McHugh, David Moore, Ronan Collins |
| Abstract |
Non-vitamin K antagonist oral anticoagulants (NOACs) are a major advance for stroke prevention in atrial fibrillation (AF). Use of the vitamin K antagonist (VKA), warfarin, has dropped 40% since 2010 in our institution. There is limited Irish hospital data on NOAC prescribing for stroke prevention. Single centre, retrospective observational cohort study of consecutive AF patients at increased risk of stroke and/or awaiting electrical cardioversion. Data on prescribed NOACs from February 2010 till July 2015 was collected from the electronic inpatient record. Appropriateness of prescriptions was based on CHA2DS2-VASC score and accuracy on individual NOAC SPCs. Potential drug interactions and bleeding risk were also quantified. A total of 348 patients AF and increased risk of stroke (CHA2DS2-VASC score > 1 for men and > 2 for women) were studied. Forty-eight percent were female with a mean age 71 ± 18.6 years, 52% of whom were > 75. Mean CHA2DS2-Vasc and HAS-BLED scores were 4.1 ± 1.8 and 1.4 ± 0.8, respectively. Rivaroxaban, dabigatran and apixaban were prescribed to 154 (54.2%), 106 (34.3%) and 41 (13.2%) patients, respectively. 20.4% had inaccurate prescriptions; 92.9% (n = 65) underdosed and 7.1% (n = 5) on inappropriately higher doses. Neither choice of NOAC, age, history of anaemia, previous bleeding or co-prescribed antiplatelets influenced the accuracy of prescription (p = NS), but decreased renal function appeared to do so (p = 0.05). Our study highlights significant inaccuracies in NOAC prescribing. Patients commenced on NOACs should be assessed and followed up in a multidisciplinary AF clinic to ensure safe and effective prescribing and stroke prevention. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Ireland | 4 | 44% |
| Germany | 1 | 11% |
| Unknown | 4 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 7 | 78% |
| Scientists | 2 | 22% |
Mendeley readers
The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 66 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 18% |
| Researcher | 9 | 14% |
| Student > Ph. D. Student | 6 | 9% |
| Other | 4 | 6% |
| Student > Doctoral Student | 2 | 3% |
| Other | 5 | 8% |
| Unknown | 28 | 42% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 27% |
| Pharmacology, Toxicology and Pharmaceutical Science | 9 | 14% |
| Nursing and Health Professions | 2 | 3% |
| Mathematics | 1 | 2% |
| Business, Management and Accounting | 1 | 2% |
| Other | 5 | 8% |
| Unknown | 30 | 45% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 February 2019.
All research outputs
#5,936,534
of 23,085,832 outputs
Outputs from Irish Journal of Medical Science
#251
of 1,432 outputs
Outputs of similar age
#103,579
of 329,907 outputs
Outputs of similar age from Irish Journal of Medical Science
#4
of 24 outputs
Altmetric has tracked 23,085,832 research outputs across all sources so far. This one has received more attention than most of these and is in the 74th percentile.
So far Altmetric has tracked 1,432 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 329,907 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.