et al. New oral anticoagulants increase risk for gastrointestinal bleeding: A systematic review and meta-analysis. em Gastroenterology /em . 2013; 145: 105C 112. [PubMed] [Google Scholar] 16. received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing. Results: Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19C0.96; = 0.039). Conclusions: Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients’ therapy, and prevent adverse drug events. test as appropriate for continuous variables, expressed as percentages; a chi-square test and Fisher’s exact test were used for categorical variables, expressed as imply standard deviation. A value 0.05 was considered to be statistically significant. Data were in the beginning came into into an Excel spreadsheet followed by analysis using Stata 13.0 (StataCorp LP, College Station, TX). RESULTS Fifty individuals and 333 doses were included in the pre-intervention group, and 85 individuals and 816 doses were included in the post-intervention group. There was no difference in baseline characteristics, except for age (Table 1). Individuals in the pre-intervention group were approximately 7 years older on average compared with the post-intervention group (= 0.002). Forty percent of individuals in the pre-intervention group received an inappropriately prescribed DOAC during hospitalization compared to 29% of individuals in the post-intervention group. There was also a decrease in the percentage of improper DOAC administrations in the post-intervention group compared to the pre-intervention group (32.4% vs 13.8%; OR 0.34; 95% CI, 0.16C0.73; = 0.005). Modifying for age and specific DOAC resulted in a decrease in the odds of improper administrations in the post-intervention group by 58% (modified OR, 0.42; 95% CI, 0.19C0.96; = 0.039). The most common DOAC that was inappropriately prescribed was apixaban, followed by rivaroxaban and dabigatran. There was clearly only one patient included in the post-intervention group who received edoxaban inappropriately. Overall, the majority of individuals who received an inappropriately prescribed DOAC were classified as having been under-dosed (Table 2). This was most generally associated with SCr, age, and excess weight criteria for apixaban dosing in individuals with atrial fibrillation: 6 individuals in the pre-intervention group and 9 individuals in the post-intervention group (Table 3). One individual in the pre-intervention group received inappropriately prescribed apixaban classified as under-dosed due to prescribing once daily as opposed to twice daily. One individual in the post-intervention group received inappropriately prescribed apixaban due to dosing on indicator. This patient was being treated for a new pulmonary embolism, and the dose was not reduced after 7 days of treatment. Additional common causes for patient’s receiving under-dosed DOACs was due to patient’s renal function: 5 individuals in the pre- treatment group and 4 individuals in the post-intervention group. The number of individuals who received an inappropriately prescribed DOAC that should have been avoided altogether was most commonly associated with renal function and/or a drug-drug connection: 4 individuals in the pre-intervention group due to renal function and a drug connection; 2 individuals in the post-intervention group due to a.et al. Effectiveness and security of novel dental anticoagulants as compared with vitamin K antagonists in the treatment of acute symptomatic venous thromboembolism: A systematic review and meta-analysis. em J Thromb Haemost /em . 2014; 12( 3): 320C 328. [PubMed] [Google Scholar] 15. January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indicator, renal function, drug interactions, and additional pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was offered to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention organizations to determine the impact of the pharmacist-driven services on appropriate DOAC prescribing. Results: Fifty individuals were analyzed in the pre-intervention group compared with 85 individuals in the post-intervention group, with a total of 333 and 816 doses given, respectively. Of the total doses given, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (modified odds ratio [OR], 0.42, 95% CI, 0.19C0.96; = 0.039). Conclusions: Implementing a pharmacist-driven DOAC program significantly improved suitable prescribing of the agents. Company education relating to DOAC use is vital to further boost suitable prescribing of DOACs, optimize sufferers’ therapy, and stop adverse drug occasions. test as befitting continuous factors, expressed simply because percentages; a chi-square ensure that you Fisher’s exact check 1-Naphthyl PP1 hydrochloride were employed for categorical factors, expressed as indicate regular deviation. A 1-Naphthyl PP1 hydrochloride worth 0.05 was regarded as statistically significant. Data had been initially inserted into an Excel spreadsheet accompanied by evaluation using Stata 13.0 (StataCorp LP, University Station, TX). Outcomes Fifty sufferers and 333 dosages were contained in the pre-intervention group, and 85 sufferers and 816 dosages were contained in the post-intervention group. There is no difference in baseline features, except for age group (Desk 1). Sufferers in the pre-intervention group had been around 7 years old on average weighed against the post-intervention group (= 0.002). Forty percent of sufferers in the pre-intervention group received an inappropriately recommended DOAC during hospitalization in comparison to 29% of sufferers in the post-intervention group. There is also a reduction in the percentage of incorrect DOAC administrations in the post-intervention group set alongside the pre-intervention group (32.4% vs 13.8%; OR 0.34; 95% CI, 0.16C0.73; = 0.005). Changing for age group and particular DOAC led to a reduction in the chances of incorrect administrations in the post-intervention group by 58% (altered OR, 0.42; 95% CI, 0.19C0.96; = 0.039). The most frequent DOAC that was inappropriately recommended was apixaban, accompanied by rivaroxaban and dabigatran. There is only one individual contained in the post-intervention group who received edoxaban inappropriately. General, nearly all sufferers who received an inappropriately recommended DOAC were categorized as having been under-dosed (Desk 2). This is most often connected with SCr, age group, and weight requirements for apixaban dosing in sufferers with atrial fibrillation: 6 sufferers in the pre-intervention group and 9 sufferers in the post-intervention group (Desk 3). One affected individual in the pre-intervention group received inappropriately recommended apixaban categorized as under-dosed because of prescribing once daily instead of double daily. One affected individual in the post-intervention group received inappropriately recommended apixaban because of dosing on sign. This patient had been treated for a fresh pulmonary embolism, as well as the dose had not been reduced after seven days of treatment. Various other common causes for patient’s getting under-dosed DOACs was because of patient’s renal function: 5 sufferers in the pre- involvement group and 4 sufferers in the post-intervention group. The amount of sufferers who received an inappropriately recommended DOAC which should have been prevented altogether was mostly connected with renal function and/or a drug-drug relationship: 4 sufferers in the pre-intervention group because of renal function and a medication relationship; 2 sufferers in the post-intervention group because of a drug relationship; and 4 sufferers in the.From the 25 sufferers who received prescribed DOACs in the post-intervention group inappropriately, 22 had a pharmacist involvement. DOACs, defined predicated on DOAC sign, renal function, medication interactions, and various other pertinent patient-specific elements. Before the begin of data collection for the post-intervention group, a pharmacist-driven process originated and applied. DOAC education was supplied to pharmacists, including an evidence-based prescribing desk to guide suitable DOAC therapy. Evaluations were made between your pre-intervention and post-intervention groupings to look for the impact from the pharmacist-driven program on suitable DOAC prescribing. Outcomes: Fifty sufferers were examined in the pre-intervention group weighed against 85 sufferers in the post-intervention group, with a complete of 333 and 816 dosages implemented, respectively. Of the full total doses implemented, 32.4% were considered inappropriate in the pre-intervention group weighed against 13.8% in the post-intervention group (altered chances ratio [OR], 0.42, 95% CI, 0.19C0.96; = 0.039). Conclusions: Implementing a pharmacist-driven DOAC program significantly improved suitable prescribing of the agents. Company education relating to DOAC use is vital to further boost suitable prescribing of DOACs, optimize sufferers’ therapy, and stop adverse drug occasions. test as befitting continuous factors, expressed simply because percentages; a chi-square ensure that you Fisher’s exact check were employed for categorical factors, expressed as indicate regular deviation. A worth 0.05 was regarded as statistically significant. Data had been initially moved into into an Excel spreadsheet accompanied by evaluation using Stata 13.0 (StataCorp LP, University Station, TX). Outcomes Fifty individuals and 333 dosages were contained in the pre-intervention group, and 85 individuals and 816 dosages were contained in the post-intervention group. There is no difference in baseline features, except for age group (Desk 1). Individuals in the pre-intervention group had been around 7 years old on average weighed against the post-intervention group (= 0.002). Forty percent of individuals in the pre-intervention group received an inappropriately recommended DOAC during hospitalization in comparison to 29% of individuals in the post-intervention group. There is also a reduction in the percentage of unacceptable DOAC administrations in the post-intervention group set alongside the pre-intervention group (32.4% vs 13.8%; OR 0.34; 95% CI, 0.16C0.73; = 0.005). Modifying for age group and particular DOAC led to a reduction in the chances of unacceptable administrations in the post-intervention group by 58% (modified OR, 0.42; 95% CI, 0.19C0.96; = 0.039). The most frequent DOAC that was inappropriately recommended was apixaban, accompanied by rivaroxaban and dabigatran. There is only one individual contained in the post-intervention group who received edoxaban inappropriately. General, nearly all individuals who received an inappropriately recommended DOAC were categorized as having been under-dosed (Desk 2). This is most often connected with SCr, age group, and weight requirements for apixaban dosing in individuals with atrial fibrillation: 6 individuals in the pre-intervention group and 9 individuals in the post-intervention group (Desk 3). One affected person in the pre-intervention group received inappropriately recommended apixaban categorized as under-dosed because of prescribing once daily instead of double daily. One affected person in the post-intervention group received inappropriately recommended apixaban because of dosing on indicator. This patient had been treated for a fresh pulmonary embolism, as well as the dose had not been reduced after seven days of treatment. Additional common causes for patient’s getting under-dosed DOACs was because of patient’s renal function: 5 individuals in the pre- treatment group and 4 individuals in the post-intervention group. The amount of individuals who received an inappropriately recommended DOAC which should have been prevented altogether was mostly connected with renal function and/or a drug-drug discussion: 4 individuals in the pre-intervention group because of renal function and a medication discussion; 2 individuals in the post-intervention group because of a drug discussion; and 4 individuals in the post-intervention group because of both renal function and a medication discussion. The amount of unacceptable DOAC doses given reduced in the post-intervention group set alongside the pre-intervention group (14% vs 26%; = 0.042). Sufferers who received an incorrect DOAC because of getting over-dosed was least common: 2 sufferers in the pre-intervention group and 4 sufferers in the post-intervention group because of SCr, age group, and weight requirements; 1 individual in the post-intervention group because of renal function; and 1 individual in the post-intervention because of dosing for sign. There is no difference between groupings when comparing the amount of sufferers who received an inappropriately recommended DOAC categorized as under-dosed or over-dosed. From the 25 sufferers who received recommended DOACs in the post-intervention group inappropriately, 22 acquired a.et al. Evaluations between book mouth supplement and anticoagulants K antagonists in sufferers with CKD. em J Am Soc Nephrol /em . 2014; 25( 3): 431C 442. [PMC free content] [PubMed] [Google Scholar] 17. produced between your post-intervention and pre-intervention groupings to look for the influence from the pharmacist-driven provider on appropriate DOAC prescribing. Outcomes: Fifty sufferers were examined in the pre-intervention group weighed against 85 sufferers in the post-intervention group, with a complete of 333 and 816 dosages implemented, respectively. Of the full total doses implemented, 32.4% were considered inappropriate in the pre-intervention group weighed against 13.8% in the post-intervention group (altered chances ratio [OR], 0.42, 95% CI, 0.19C0.96; = 0.039). Conclusions: Implementing a pharmacist-driven DOAC provider significantly improved suitable prescribing of the agents. Company education relating to DOAC use is vital to further boost suitable prescribing of DOACs, optimize sufferers’ therapy, and stop adverse drug occasions. test as befitting continuous factors, expressed simply because percentages; a chi-square ensure that you Fisher’s exact check were employed for categorical factors, expressed as indicate regular deviation. A worth 0.05 was regarded as statistically significant. Data had been initially got into into an Excel spreadsheet accompanied by evaluation using Stata 13.0 (StataCorp LP, University Station, TX). Outcomes Fifty sufferers and 333 dosages were contained in the pre-intervention group, and 85 sufferers and 816 dosages were contained in the post-intervention group. There is no difference in baseline features, except for age group (Desk 1). Sufferers in the pre-intervention group had been around 7 years old on average weighed against the post-intervention group (= 0.002). Forty percent of sufferers in the pre-intervention group received an inappropriately recommended DOAC during hospitalization in comparison to 29% of sufferers in the post-intervention group. There is also a reduction in the percentage of incorrect DOAC administrations in the post-intervention group set alongside the pre-intervention group (32.4% vs 13.8%; OR 0.34; 95% CI, 0.16C0.73; = 0.005). Changing 1-Naphthyl PP1 hydrochloride for age group and particular DOAC led to a reduction in the chances of incorrect administrations in the post-intervention group by 58% (altered OR, 0.42; 95% CI, 0.19C0.96; = 0.039). The most frequent DOAC that was inappropriately recommended was apixaban, accompanied by rivaroxaban and dabigatran. There is only one individual contained in the post-intervention group who received edoxaban inappropriately. General, nearly all sufferers who received an inappropriately recommended DOAC were categorized as having been under-dosed (Desk 2). This is most often connected with SCr, age group, and weight requirements for apixaban dosing in sufferers with atrial fibrillation: 6 sufferers in the pre-intervention group and 9 sufferers in the post-intervention group (Desk 3). One affected individual in the pre-intervention group received inappropriately recommended apixaban categorized as under-dosed because of prescribing once daily instead of double daily. One affected individual in the post-intervention group received inappropriately recommended apixaban because of dosing on sign. This patient had been treated for a fresh pulmonary embolism, as well as the dose had not been reduced after seven days of treatment. Various other common causes for patient’s getting under-dosed DOACs was due to patient’s renal function: 5 individuals in the pre- treatment group and 4 individuals in the post-intervention group. The number of individuals who received an inappropriately prescribed DOAC that should have been avoided altogether was most commonly associated with renal function and/or a drug-drug connection: 4 individuals in the pre-intervention group due to renal function and a drug connection; 2 individuals in the post-intervention group due to a drug connection; and 4 individuals in the post-intervention group due to both Rabbit Polyclonal to Acetyl-CoA Carboxylase renal function and a drug connection. The number of improper DOAC doses given decreased in the post-intervention group compared to the pre-intervention group (14% vs 26%; = 0.042). Individuals who received an improper DOAC due to becoming over-dosed was least common: 2 individuals in the pre-intervention group and 4 individuals in the post-intervention group due to SCr, age, and weight criteria; 1 patient in the post-intervention group due to renal function; and 1 patient in the post-intervention due to dosing for indicator. There was no difference between organizations when comparing the number of individuals who received an inappropriately prescribed DOAC classified as under-dosed.This patient was being treated for a new pulmonary embolism, and the dose was not reduced after 7 days of treatment. on DOAC indicator, renal function, drug interactions, and additional pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was offered to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention organizations to determine the impact of the pharmacist-driven services on appropriate DOAC prescribing. Results: Fifty individuals were analyzed in the pre-intervention group compared with 85 individuals in the post-intervention group, with a total of 333 and 816 doses given, respectively. Of the total doses given, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (modified odds ratio [OR], 0.42, 95% CI, 0.19C0.96; = 0.039). Conclusions: Implementing a pharmacist-driven DOAC services significantly improved appropriate prescribing of these agents. Supplier education concerning DOAC use is essential to further increase appropriate prescribing of DOACs, optimize individuals’ therapy, and prevent adverse drug events. test as appropriate for continuous variables, expressed mainly because percentages; a chi-square test and Fisher’s exact test were utilized for categorical variables, expressed as imply standard deviation. A value 0.05 was considered to be statistically significant. Data were initially came into into an Excel spreadsheet followed by analysis using Stata 13.0 (StataCorp LP, College Station, TX). RESULTS Fifty individuals and 333 doses were included in the pre-intervention group, and 85 individuals and 816 doses were included in the post-intervention group. There was no difference in baseline characteristics, except for age (Table 1). Individuals in the pre-intervention group were approximately 7 years older on average compared with the post-intervention group (= 0.002). Forty percent of individuals in the pre-intervention group received an inappropriately prescribed DOAC during hospitalization compared to 29% of patients in the post-intervention group. There was also a decrease in the percentage of inappropriate DOAC administrations in the post-intervention group compared to the pre-intervention group (32.4% vs 13.8%; OR 0.34; 95% CI, 0.16C0.73; = 0.005). Adjusting for age and specific DOAC resulted in a decrease in the odds of inappropriate administrations in the post-intervention group by 58% (adjusted OR, 0.42; 95% CI, 0.19C0.96; = 0.039). The most common DOAC that was inappropriately prescribed was apixaban, followed by rivaroxaban and dabigatran. There was only one patient included in the post-intervention group who received edoxaban inappropriately. Overall, the majority of patients who received an inappropriately prescribed DOAC were classified as having been under-dosed (Table 2). This was most commonly associated with SCr, age, and weight criteria for apixaban dosing in patients with atrial fibrillation: 6 patients in the pre-intervention group and 9 patients in the post-intervention group (Table 3). One patient in the pre-intervention group received inappropriately prescribed apixaban classified as under-dosed due to prescribing once daily as opposed to twice daily. One patient in the post-intervention group received inappropriately prescribed apixaban due to dosing on indication. This patient was being treated for a new pulmonary embolism, and the dose was not reduced after 7 days of treatment. Other common causes for patient’s receiving under-dosed DOACs was due to patient’s renal function: 5 patients in the pre- intervention group and 4 patients in the post-intervention group. The number of patients who received an inappropriately prescribed DOAC that should have been avoided altogether was most commonly associated with renal function and/or a drug-drug conversation: 4 patients in the pre-intervention group due to renal function and a drug conversation; 2 patients in the post-intervention group due to a drug conversation;.