학술논문
Pharmacist-led interventions in optimising the use of oral anticoagulants in patients with atrial fibrillation in general practice in England: a retrospective observational study.
Document Type
Academic Journal
Author
Sharma R; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.; Hasan SS; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.; Gilkar IA; Little Horton Lane Medical Centre, Bradford, UK.; Hussain WF; Clarendon Medical Centre, Bradford, UK.; Conway BR; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.; Ghori MU; Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK m.ghori@hud.ac.uk.
Source
Publisher: Royal College of General Practitioners Country of Publication: England NLM ID: 101713531 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2398-3795 (Electronic) Linking ISSN: 23983795 NLM ISO Abbreviation: BJGP Open Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Background: Oral anticoagulation (OAC) is the mainstay of treatment for the prevention of strokes in patients with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) account for increasing OAC in patients with AF. However, prescribing DOACs for patients with established AF poses various challenges and general practice pharmacists may have an important role in supporting their management.
Aim: To investigate the effectiveness of pharmacist-led interventions in general practice in optimising the use of OAC therapies in AF.
Design & Setting: A retrospective observational study in general practices in Bradford.
Method: The data were collected retrospectively from 1 November 2018-31 December 2019 using electronic health record data. The data were analysed: 1) to identify patients with AF not on OAC; 2) to describe inappropriate DOAC prescriptions; and 3) to calculate HAS-BLED scores.
Results: Overall, 76.3% ( n = 470) of patients with AF received OAC therapy, and of these, 63.4% received DOACs. Pharmacist-led interventions increased DOAC prescribing by 6.0% ( P = 0.03). Inappropriate DOAC use was identified in 24.5% of patients with AF, with underdosed and overdosed identified in 9.7% and 14.8%, respectively. Post-intervention, inappropriate prescribing was reduced to 1.7%. The mean HAS-BLED score decreased from 3.00 to 2.22 ( P <0.01). Successful transition from vitamin K antagonist (VKA) therapy to DOACs was achieved in 25.7% of patients.
Conclusion: Pharmacist-led interventions have successfully improved the use of OAC therapies in patients with AF, and effectively managed the bleeding risks and transition from VKA to DOAC therapy, in line with guidelines.
(Copyright © 2024, The Authors.)
Aim: To investigate the effectiveness of pharmacist-led interventions in general practice in optimising the use of OAC therapies in AF.
Design & Setting: A retrospective observational study in general practices in Bradford.
Method: The data were collected retrospectively from 1 November 2018-31 December 2019 using electronic health record data. The data were analysed: 1) to identify patients with AF not on OAC; 2) to describe inappropriate DOAC prescriptions; and 3) to calculate HAS-BLED scores.
Results: Overall, 76.3% ( n = 470) of patients with AF received OAC therapy, and of these, 63.4% received DOACs. Pharmacist-led interventions increased DOAC prescribing by 6.0% ( P = 0.03). Inappropriate DOAC use was identified in 24.5% of patients with AF, with underdosed and overdosed identified in 9.7% and 14.8%, respectively. Post-intervention, inappropriate prescribing was reduced to 1.7%. The mean HAS-BLED score decreased from 3.00 to 2.22 ( P <0.01). Successful transition from vitamin K antagonist (VKA) therapy to DOACs was achieved in 25.7% of patients.
Conclusion: Pharmacist-led interventions have successfully improved the use of OAC therapies in patients with AF, and effectively managed the bleeding risks and transition from VKA to DOAC therapy, in line with guidelines.
(Copyright © 2024, The Authors.)