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    Suboptimal use of oral anticoagulants in atrial fibrillation: Has the introduction of direct oral anticoagulants improved prescribing practices?

    Access Status
    Fulltext not available
    Authors
    Alamneh, E.
    Stafford, Leanne
    Bereznicki, L.
    Date
    2016
    Type
    Journal Article
    
    Metadata
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    Citation
    Alamneh, E. and Stafford, L. and Bereznicki, L. 2016. Suboptimal use of oral anticoagulants in atrial fibrillation: Has the introduction of direct oral anticoagulants improved prescribing practices?. American Journal of Cardiovascular Drugs. 16 (3): pp. 183-200.
    Source Title
    American Journal of Cardiovascular Drugs
    DOI
    10.1007/s40256-016-0161-8
    ISSN
    1175-3277
    School
    School of Pharmacy
    URI
    http://hdl.handle.net/20.500.11937/58608
    Collection
    • Curtin Research Publications
    Abstract

    © Springer International Publishing Switzerland 2016.Background and Objectives: Atrial fibrillation (AF) and the associated risk of stroke are emerging epidemics throughout the world. Suboptimal use of oral anticoagulants for stroke prevention has been widely reported from observational studies. In recent years, direct oral anticoagulants (DOACs) have been introduced for thromboprophylaxis. We conducted a systematic literature review to evaluate current practices of anticoagulation in AF, pharmacologic features and adoption patterns of DOACs, their impacts on proportion of eligible patients with AF who receive oral anticoagulants, persisting challenges and future prospects for optimal anticoagulation. Literature Source and Selection Criteria: In conducting this review, we considered the results of relevant prospective and retrospective observational studies from real-world practice settings. PubMed (MEDLINE), Scopus (RIS), Google Scholar, EMBASE and Web of Science were used to source relevant literature. There were no date limitations, while language was limited to English. Selection was limited to articles from peer reviewed journals and related to our topic. Results: Most studies identified in this review indicated suboptimal use of anticoagulants is a persisting challenge despite the availability of DOACs. Underuse of oral anticoagulants is apparent particularly in patients with a high risk of stroke. DOAC adoption trends are quite variable, with slow integration into clinical practice reported in most countries; there has been limited impact to date on prescribing practice. Conclusion: Available data from clinical practice suggest that suboptimal oral anticoagulant use in patients with AF and poor compliance with guidelines still remain commonplace despite transition to a new era of anticoagulation featuring DOACs.

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