Fecha de recepción: 22/03/2018 – Fecha de aceptación: 18/06/2018
Guisado-Gil AB1, Herrera-Hidalgo L1, Cantillana-Suárez MG2, Sánchez-Pedrosa A2, Saborido-Cansino C2
1 Servicio de Farmacia. Hospital Universitario Virgen del Rocío. Sevilla (España)
2 Servicio de Farmacia. Área de Gestión Sanitaria Sevilla Sur. Sevilla (España)
Guisado-Gil AB w Hospital Universitario Virgen del Rocío (Servicio de Farmacia) w Avda. Manuel Siurot, s/n w 41013 Sevilla (España)
Background and objectives: To evaluate the adequacy of the prescribed dose of direct oral anticoagulants (DOAC) in patients with non-valvular atrial fibrillation (NVAF) and to assess the percentage of acceptance of pharmaceutical intervention (PI) by physicians after the issuance of dosage adjustment recommendations by the Pharmacy Service.
Patients: Prospective study conducted by the Pharmacy Service of a Healthcare Management Area for adult patients diagnosed with NVAF and with active prescription of DOAC during July and August of 2017. The main variable was the dose adequacy, and as secondary variable, the percentage of acceptance of the PI was measured. The dose review was performed based on the report for the use of DOAC in the prevention of stroke and systemic embolism in patients with NVAF by “Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)” and the technical specifications of each drug. Patients with inadequate dose were classified as underdosed or overdosed.
Results: 60 (9%) inadequate prescriptions were identified, 75% due to overdosage. The distribution by drug was: 23 dabigatran, 30 rivaroxaban, 2 apixaban and 5 edoxaban. Fifty-two cases of inadequate prescriptions were reported. The percentage of acceptance of the PI was 26.9%. There was no dose modification in the underdosed patients.
Conclusions: The number of patients with inadequate dose of DOAC was low, mostly due to overdosage. The percentage of acceptance of the PI was relatively low, especially in underdosed patients.
Key Words: Dabigatran, rivaroxaban, edoxaban, apixaban, atrial fibrillation, dosage.