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The therapeutic index for anticoagulants is narrow: Taking a few more pills than recommended might induce bleeding, and missing a few doses can result in thrombosis. Routine monitoring detects whether patients adhere to dosing recommendations for the standard anticoagulants heparin and warfarin, but monitoring is not required with the current generation of anticoagulants.
To determine whether patients are adhering to dosing recommendations for the new oral anticoagulant dabigatran, investigators conducted phone interviews and reviewed pharmacy records for 103 patients (mean age, 75.5 years) who were followed by a thrombosis service. Patients had been taking dabigatran (110 mg or 150 mg twice daily) for an average of 13 months. They were seen…