Determinants of Inappropriate Dosing of Direct Oral Anticoagulants in Non-Valvular Atrial Fibrillation in a Low-Income Country DOI Open Access

F. Baez,

G. Mejía,

Laiden Suárez Fuster

et al.

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 26, 2024

Introduction The appropriate use of direct oral anticoagulants (DOACs) is crucial in patients with non-valvular atrial fibrillation (NVAF) to prevent thromboembolic complications. inappropriate doses common, but information on its prevalence and determining factors low-income countries insufficient. Objective objective this study quantify the identify demographic, clinical, treatment-related associated dosing DOACs NVAF a country. Methods A retrospective observational was conducted from June 2023 July 2024 at Dominican Institute Cardiology Association. Outpatients over 18 years age diagnosis treatment were included classified into two groups based dose appropriateness. Univariate analyses, such as chi-square Student's t-tests or Mann-Whitney U tests, used, along multivariate logistic regression analysis, adjust for potential confounding factors. Results In involving 392 treated DOACs, 72.19% (283 patients) received doses, whereas 27.81% (109 dosed inappropriately. Specifically, 15.56% underdosed 12.24% overdosed. Among 268 prescribed apixaban, 71.64% an dose, 28.36% 80.26% these cases low doses. Furthermore, significantly greater proportion apixaban reduced 2.5 mg every 12 hours (p<0.001). contrast, 73.39% 124 rivaroxaban had dosing, 26.61% inappropriately, all which overdoses. Patients who older (79.22 vs. 76.06 years; p=0.006), higher serum creatinine levels (1.23 1.1 mg/dL; p=0.004), lower clearance (39.38 51.69 mL/min; p<0.001). vascular disease (15.60% 7.77%; p=0.02) anemia (7.34% 1.77%; p=0.01) also group. Multivariate analysis identified advanced (OR=1.04; 95% CI: 1.01-1.06; (OR=2.28; 1.11-4.67; p=0.024), elevated (OR=2.00; 1.1-3.63; p=0.024) significant predictors dosing. Conclusion found that primarily due underdosing. Significant inadequacy age, clearance, disease.

Language: Английский

Quality of prescribing and health-related quality of life in older adults: a narrative review with a special focus on patients with atrial fibrillation and multimorbidity DOI Creative Commons
Cheïma Amrouch, Deirdre A. Lane, Amaia Calderón‐Larrañaga

et al.

European Geriatric Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 9, 2025

Abstract Purpose To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those atrial fibrillation (AF) multimorbidity, while exploring potential interventions to improve their impact HRQOL. Methods A comprehensive search strategy was conducted MEDLINE using PubMed interface August 16th, 2024, focusing key terms related “potentially prescribing” “quality life”. Additionally, reference lists included studies were screened. Only utilising validated assessment tools for HRQOL or measuring global self-perceived health status considered. Studies involving populations an average age ≥ 65 years included. Results Of 1810 articles screened, 35 The findings indicate that prescribing, independent polypharmacy, may negatively influence review identified range aimed at improving among including pharmacist-driven, general practitioner-driven, multidisciplinary approaches. Interventions assessed distinct population groups specifically residential care homes. While some demonstrated improvements quality, overall evidence regarding remains limited. Conclusion relationship underexplored adults AF despite high prevalence PIP. Effective pharmacotherapy should be coupled patients' clinical functional parameters, considering Adopting multidisciplinary, integrated, patient-centred approach is essential sustainable appropriate practices enhance

Language: Английский

Citations

0
Frailty in patients with atrial fibrillation: diagnosis, management, prevention and influence on prognosis DOI Open Access
Е. С. Кропачева,

M. I. Dashaeva,

Е. П. Панченко

et al.

Russian Cardiology Bulletin, Journal Year: 2025, Volume and Issue: 20(1), P. 5 - 5

Published: April 14, 2025

The review is devoted to frailty in patients with atrial fibrillation (AF). number of elderly AF constantly increasing, and this category characterized by high incidence stroke bleeding. Frailty a key geriatric syndrome. Research extremely important, since involutional processes cardiovascular system, brain, kidneys gastrointestinal tract cause metabolism anticoagulants increase the risk thromboembolic hemorrhagic complications. highlights tools, scales questionnaires for assessing diseases. In addition, some biomarkers related syndromes are described. Data on negative impact prognosis presented, measures prevent its progression outlined. These data indicate need introduce tools into interdisciplinary approach. This can delay loss working capacity, improve quality life outcomes senile AF.

Language: Английский

Citations

0
Determinants of Inappropriate Dosing of Direct Oral Anticoagulants in Non-Valvular Atrial Fibrillation in a Low-Income Country DOI Open Access

F. Baez,

G. Mejía,

Laiden Suárez Fuster

et al.

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 26, 2024

Introduction The appropriate use of direct oral anticoagulants (DOACs) is crucial in patients with non-valvular atrial fibrillation (NVAF) to prevent thromboembolic complications. inappropriate doses common, but information on its prevalence and determining factors low-income countries insufficient. Objective objective this study quantify the identify demographic, clinical, treatment-related associated dosing DOACs NVAF a country. Methods A retrospective observational was conducted from June 2023 July 2024 at Dominican Institute Cardiology Association. Outpatients over 18 years age diagnosis treatment were included classified into two groups based dose appropriateness. Univariate analyses, such as chi-square Student's t-tests or Mann-Whitney U tests, used, along multivariate logistic regression analysis, adjust for potential confounding factors. Results In involving 392 treated DOACs, 72.19% (283 patients) received doses, whereas 27.81% (109 dosed inappropriately. Specifically, 15.56% underdosed 12.24% overdosed. Among 268 prescribed apixaban, 71.64% an dose, 28.36% 80.26% these cases low doses. Furthermore, significantly greater proportion apixaban reduced 2.5 mg every 12 hours (p<0.001). contrast, 73.39% 124 rivaroxaban had dosing, 26.61% inappropriately, all which overdoses. Patients who older (79.22 vs. 76.06 years; p=0.006), higher serum creatinine levels (1.23 1.1 mg/dL; p=0.004), lower clearance (39.38 51.69 mL/min; p<0.001). vascular disease (15.60% 7.77%; p=0.02) anemia (7.34% 1.77%; p=0.01) also group. Multivariate analysis identified advanced (OR=1.04; 95% CI: 1.01-1.06; (OR=2.28; 1.11-4.67; p=0.024), elevated (OR=2.00; 1.1-3.63; p=0.024) significant predictors dosing. Conclusion found that primarily due underdosing. Significant inadequacy age, clearance, disease.

Language: Английский

Citations

0