PREDICTORS AND PREVALENCE OF INACCURATE DOSING OF DIRECT ORAL ANTICOAGULANTS

A MUQEET; S SAEED; MSN KHAN

doi:10.54112/bcsrj.v2023i1.455

Authors

A MUQEET Department of Cardiology, Jinnah Hospital Lahore, Pakistan
S SAEED Respiratory Ward, Good Hope Hospital Birmingham, UK
MSN KHAN Department of Medicine, MMDC & Ibe Sina Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.455

Keywords:

Direct oral anti-coagulants, Under dosing, Over dosing

Abstract

The retrospective study was conducted in tertiary care hospitals from January 2022 to June 2022 to investigate predictors and prevalence of inaccurate dosing of DOACs. The study included patients who were prescribed and taking DOAC during their admission to the hospital or before admission. The study was conducted on a total of 200 patients. Dosing appropriateness was assessed by checking if it was consistent with the AHA guidelines. 42 (21%) patients had inappropriate dosing, 25 (59.5%) were overdosed, and 17 (40.4%) were underdosed. According to univariate analysis, older age, lower CrCl, higher HAS-BLED, CHA2DS2-VASc, CCI, and prescription before admission were significantly associated with inappropriate dosing. It is concluded that inappropriate dosing, particularly under-dosing, of DOAC occurs commonly during clinical practice. DOACs should be prescribed carefully in outpatient settings and patients with renal dysfunction.

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