Appropriateness of Prescribing Dabigatran Etexilate and Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation

Larock, Anne-Sophie; Mullier, François; Sennesael, Anne-Laure; Douxfils, Jonathan; Devalet, Bérangère; Chatelain, C; Dogné, Jean‐Michel; Spinewine, Anne

doi:10.1177/1060028014540868

Cited by 84 publications

(88 citation statements)

References 48 publications

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“…This finding is consistent, albeit with a greater incidence, with findings in the study by Larock and others, 6 in which 26% of patients were receiving an inappropriate dosage of rivaroxaban or dabigatran.…”

Section: Discussionsupporting

confidence: 81%

“…In a recent study, 49% of patients were receiving dabigatran or rivaroxaban inappropriately as a result of, among other reasons, inappropriate medication choice, prescription of the wrong dosage, or improper administration (e.g., rivaroxaban taken on an empty stomach). 6 In another study, 19% of patients were receiving an inappropriate dose of a direct oral anticoagulant, and an additional 14% were using their direct oral anticoagulants inappropriately. 7 However, a literature search conducted in April 2016 revealed that the appropriateness of apixaban prescribing had not been specifically evaluated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Appropriateness of Apixaban Dosing to Prevent Stroke in Patients with Atrial Fibrillation: A Pilot Study

Carlin

Pickering

Schulman³

2016

CJHP

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Background:The ARISTOTLE study investigated apixaban, at a dose of 5 mg PO bid, for the prevention of stroke in patients with atrial fibrillation; however, it has been noted anecdotally that many patients are receiving 2.5 mg PO bid, despite being eligible for the full dosage. A recent study examining the use of dabigatran and rivaroxaban found that many patients were receiving these medications inappropriately; however, a literature search conducted in April 2016 showed that apixaban had not been formally studied in this context.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Appropriateness of Apixaban Dosing to Prevent Stroke in Patients with Atrial Fibrillation: A Pilot Study

Carlin

Pickering

Schulman³

2016

CJHP

View full text Add to dashboard Cite

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“…Concerns with the safety and the potential budget impact of dabigatran when prescribed in more elderly co-morbid populations that those recruited into Phase III clinical trials (13,41,117). These concerns resulted in a number of professional bodies and health authorities initiating extensive preand peri-launch programmes, some of which are listed in Table A1 (Appendix).…”

Section: Ii) Dabigatran To Prevent Stroke and Systemic Embolism/clot mentioning

confidence: 99%

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Godman

Malmström

Diogène³

et al. 2014

Expert Review of Clinical Pharmacology

116

132

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Are new models needed to optimise the utilisation of new medicines to sustain healthcare systems?Godman B 1,2,3 , Malmström RE 4 , Diogene E 5 , Gray A 6 , Jayathissa S 7 , Timoney A 8 , Acurcio FA 9,10 , Alkan A 11 , Brzezinska A 12 , Bucsics A 13 , Campbell S 14,15 AbstractIntroduction: Medicines have made an appreciable contribution to improving health. However, even high income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimise their use. Objective: Review case histories among health authorities to improve the utilisation and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. Challenges and proposed models: A number of issues and challenges have been identified including the limited innovation level of new medicines alongside increasing requested prices for their reimbursement especially for oncology, orphan diseases, diabetes and HCV. Models centre on the three pillars of pre-, peri, and post-launch including critical drug evaluation and multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure Discussion: Proposed models which involve all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.

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“…6 Additional data suggest that serum dabigatran levels can vary widely when administered correctly 4 and that off-label prescribing, incorrect dosing and dosage administration errors are not uncommon. 7 We analyzed time trends in atraumatic intracranial bleeding treated at a Canadian neurosurgical centre during the period when the direct oral anticoagulants were introduced.…”

mentioning

confidence: 99%

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

et al. 2015

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Appropriateness of Prescribing Dabigatran Etexilate and Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation

Abstract: Inappropriate use of DE and rivaroxaban in patients with NVAF is frequent and possibly leads to AEs. Reinforcing education of health care professionals and patients is needed. Collaboration with clinical pharmacists can contribute to better use.

Cited by 84 publications

References 48 publications

Appropriateness of Apixaban Dosing to Prevent Stroke in Patients with Atrial Fibrillation: A Pilot Study

Appropriateness of Apixaban Dosing to Prevent Stroke in Patients with Atrial Fibrillation: A Pilot Study

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

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