Patient Transitions and Oral Anticoagulant Safety: A Population-Based Cohort

Holbrook, Anne; Paterson, Michael; Martins, Dimitri; Greaves, Simón; Benipal, Harsukh; Gomes, Thalles Oliveira

doi:10.1016/j.cjca.2018.07.367

Cited by 1 publication

(3 citation statements)

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“…This is feasible as a similar study reported haemorrhage and thromboembolic event rates of about 26 and 34 per 100 person-years in the first 30-day post-discharge, respectively, in a cohort of 123 140 patients. 8 In addition, the long accrual period will also help ensure a sufficient sample size.…”

Section: Sample Sizementioning

confidence: 99%

“…Among the elderly, a bleeding risk of 26.4% (95% CI 25.3-27.4) per person-year and a thromboembolic event risk of 32.4% (95% CI 31.3 to 33.5) per person-year were identified in OAC users within the first 30 days after hospital discharge. 8 The high rates of adverse events in the early post-discharge period suggest that continuity of care during this hectic time for patients transitioning out of the hospital may be part of the problem. 9 10 Continuity of care is defined by the WHO as 'the degree to which discrete Strengths and limitations of this study ► Few studies have examined factors that predict medication safety adverse events during periods of transitions of care.…”

Section: Introductionmentioning

confidence: 99%

“…Among the elderly, a bleeding risk of 26.4% (95% CI 25.3–27.4) per person-year and a thromboembolic event risk of 32.4% (95% CI 31.3 to 33.5) per person-year were identified in OAC users within the first 30 days after hospital discharge. 8 …”

Section: Introductionmentioning

confidence: 99%

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Predictors of oral anticoagulant-associated adverse events in seniors transitioning from hospital to home: a retrospective cohort study protocol

et al. 2020

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IntroductionOral anticoagulants (OACs) are widely prescribed in older adults. High OAC-related adverse event rates in the early period following hospital discharge argue for an analysis to identify predictors. Our objective is to identify and validate clinical and continuity of care variables among seniors discharged from hospital on an OAC, which are independently associated with OAC-related adverse events within 30 days.Methods and analysisWe propose a population-based retrospective cohort study of all adults aged 66 years or older who were discharged from hospital on an OAC from September 2010 to March 2015 in Ontario, Canada. The primary outcome is a composite of the first hospitalisation or emergency department visit for a haemorrhage or thromboembolic event or mortality within 30 days of hospital discharge. A Cox proportional hazards model will be used to determine the association between the composite outcome and a set of prespecified covariates. A split sample method will be adopted to validate the variables associated with OAC-related adverse events.Ethics and disseminationThe use of data in this project was authorised under section 45 of Ontario’s Personal Health Information Protection Act, which does not require review by a research ethics board. Results will be disseminated via peer-reviewed publications and presentations at conferences and will determine intervention targets to improve OAC management in upcoming randomised trials.Trial registration numberClinicalTrials.gov Identifier: NCT02777047; Pre-results.

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Section: Sample Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%