Medication Errors associated with Direct Oral Anticoagulants: A Systematic Review
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Abstract
Background: Direct oral anticoagulants (DOACs) have favorable safety and efficacy outcomes in treating and preventing different thrombotic events compared to warfarin. DOACs are mainly eliminated through the kidney; therefore, poor renal function is one of the important patient-related factors related to DOACs prescription errors. Our objective was to systematically review evidence related to the prevalence, risk factors, and characteristics of inappropriate DOACs prescription practices.
Methods: The search was conducted in PubMed and Scopus databases from 2011to 2021. We included any study that involved DOACs use among adults >18. Modified Newcastle-Ottawa Scale was used to assess the quality of selected articles.
Results: As a result of our search strategy, we found 19 articles that met the inclusion criteria. The prevalence of DOACs inappropriate prescription ranged from 6% to 60%. The most commonly reported inappropriate prescription was underdosing. Renal impairment was an important factor related to inappropriate DOACs prescriptions.
Conclusion: Appropriateness of the DOACs prescription practice remains a concern, with underdosing as the most reported dosing-related problem. Renal impairment among the patients-related factors increases the risk of inappropriate dosing.
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