Use of Direct-Acting Oral Anticoagulants in the Real World

Analysis of registry data reveals that many patients are not receiving the recommended doses — and the recommended care.

Are prescribers are correctly dosing direct-acting oral anticoagulants (DOACs)? To find out, researchers analyzed 3 years of data (2013–2016) from a U.S. multisite prospective registry of patients with atrial fibrillation (AF).

After exclusion of 721 patients with missing renal function data, 42 patients with valvular AF, and 2000 patients not seen in follow-up, the cohort involved 5738 DOAC-treated patients. Rivaroxaban was prescribed to 3078 patients, apixaban to 2235, and dabigatran to 425. Mean follow-up was 1 year.

Overall, 5000 patients were receiving doses consistent with the package insert recommendations (87%), 541 were receiving lower doses (9.4%), and 197 were receiving higher ones (3.4%). Patients receiving higher or lower doses w…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Use of Direct-Acting Oral Anticoagulants in the Real World

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Reviewing Author