DOAC drug interactions management resource

Chadha, Ayush; Guirguis, Micheal; Bungard, Tammy J.

doi:10.1177/17151635221116100

Cited by 5 publications

(3 citation statements)

References 57 publications

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“…The other three developed use cases focus on prescribing direct oral anticoagulants (DOAC) in patients with Non-Valvular Atrial Fibrillation (AF) and for the treatment and prevention of venous thromboembolism (VTE) [13]. The T2D use cases were inspired by case studies aimed at training clinicians [14] and the DOAC related use cases were inspired by use cases published previously in the Hospitalist [15]. The intention behind creating these use cases for diagnoses and prescription was to showcase that FHIR standards and CQL are able to be used in both of these categories.…”

Section: Methodsmentioning

confidence: 99%

Interdisciplinary Teams in Health Informatics: Using FHIR Standards to Share Computable Knowledge

Andrikopoulou

Schreiweis

Anywar

2023

Caring Is Sharing – Exploiting the Value in Data for Health and Innovation

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The use and shareability of Clinical Quality Language (CQL) artefacts is an important aspect in enabling the exchange and interoperability of clinical data to support both clinical decisions and research in the medical informatics field. This paper, while basing on use cases and synthetic data, developed purposeful CQL reusable libraries to showcase the possibilities of multidisciplinary teams and how CQLs could be best used to support clinical decision making.

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Section: Methodsmentioning

confidence: 99%

Interdisciplinary Teams in Health Informatics: Using FHIR Standards to Share Computable Knowledge

Andrikopoulou

Schreiweis

Anywar

2023

Caring Is Sharing – Exploiting the Value in Data for Health and Innovation

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“…Direct oral anticoagulant DLM has potential to detect known or novel drug interactions that may impact the safety and efficacy of DOAC therapy. A recently published DOAC drug interaction tool 31 highlights detailed pharmacokinetics and serves as a comprehensive resource for clinicians to navigate the complex landscape of potential medication interactions and their implications for patient care. The highest risk medication groups with interactions include antiepileptic agents, azole antifungal agents, select antibacterial agents, and select antiarrhythmic agents, typically by strong induction or inhibition of CYP3A4 and/or p-gp.…”

Section: Challenge #1: How Can We Classify “High Risk” Patients That ...mentioning

confidence: 99%

“…The highest risk medication groups with interactions include antiepileptic agents, azole antifungal agents, select antibacterial agents, and select antiarrhythmic agents, typically by strong induction or inhibition of CYP3A4 and/or p-gp. 31 …”

Section: Challenge #1: How Can We Classify “High Risk” Patients That ...mentioning

confidence: 99%

Challenges to Laboratory Monitoring of Direct Oral Anticoagulants

Qiao,

Tran

2024

Clin Appl Thromb Hemost

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Direct oral anticoagulants (DOACs) exert anticoagulation effect by directly inhibiting Factor Xa (rivaroxaban, apixaban, and edoxaban) or thrombin (dabigatran). Though DOACs are characterized by fixed-dose prescribing and generally do not require routine laboratory drug-level monitoring (DLM), circumstances may arise where the DLM may aid in clinical decision-making, including DOAC dose adjustment, anticoagulant class change, or decisions to withhold or administer reversal agents. We review the current literature that describes high-risk patient groups in which DLM may be beneficial for improved patient anticoagulation management and stewardship. The review also summarizes the limitations of conventional coagulation testing and discuss the emerging utility of quantitative methods for routine and rapid emergent evaluation of DOAC drug levels—in particular, the Anti-Xa activity to detect Factor Xa Inhibitors (rivaroxaban, apixaban, and edoxaban). Both technical and regulatory barriers to widespread DLM implementation are limiting factors to further clinical research that must be overcome, in order to propose universal DOAC DLM strategies and provide clinical-laboratory correlation to formally classify high-risk patient groups.

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