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DC Field | Value | Language |
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dc.contributor.author | Phannita Wattanaruengchai | en_US |
dc.contributor.author | Surakit Nathisuwan | en_US |
dc.contributor.author | Wipharak Rattanavipanon | en_US |
dc.contributor.author | Suvatna Chulavatnatol | en_US |
dc.contributor.author | Junporn Kongwatcharapong | en_US |
dc.contributor.author | Phatcharin Mitsuntisuk | en_US |
dc.contributor.author | Thanaputt Chaiyasothi | en_US |
dc.contributor.author | Duangkamon Kritsanapipat | en_US |
dc.contributor.author | Arintaya Phrommintikul | en_US |
dc.contributor.author | Nathorn Chaiyakunapruk | en_US |
dc.contributor.author | Khanchit Likittanasombat | en_US |
dc.contributor.author | Gregory Y.H. Lip | en_US |
dc.date.accessioned | 2020-10-14T08:45:53Z | - |
dc.date.available | 2020-10-14T08:45:53Z | - |
dc.date.issued | 2020-01-01 | en_US |
dc.identifier.issn | 13652125 | en_US |
dc.identifier.issn | 03065251 | en_US |
dc.identifier.other | 2-s2.0-85090448785 | en_US |
dc.identifier.other | 10.1111/bcp.14535 | en_US |
dc.identifier.uri | https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85090448785&origin=inward | en_US |
dc.identifier.uri | http://cmuir.cmu.ac.th/jspui/handle/6653943832/70976 | - |
dc.description.abstract | © 2020 The British Pharmacological Society Aims: This study aimed to evaluate the prescriber compliance to the approved labels of direct oral anticoagulants (DOACs) and impact of appropriateness of dosing on clinical outcomes. Methods: A retrospective study was conducted using simple-stratified random sampling of adult patients receiving ≥6 months of DOACs for various indications during 2013–2017 in 10 tertiary care hospitals. Patients were classified into 3 dosing groups including approved dose, underdosing and overdosing based on the Thai Food and Drug Administration-approved labels. Cox proportional hazard models were used to evaluate the impact of different dosings on thromboembolic and bleeding events. Results: From 1200 patients included in the data analysis, prescribing of DOACs was consistent with the approved indications in 1130 cases (94.2%) while 70 patients (5.8%) received DOACs despite having contraindications or with off-label usage. Among 1026 cases of dosing evaluation cohort, 688 patients (67.1%) received approved doses. There were 227 (21.9%) and 110 (10.7%) cases of underdosing and overdosing, respectively. Multivariate analysis showed that underdosing was associated with an increased risk of thromboembolism 3.023 (95% confidence interval [CI]: 1.291–7.080; P =.011) while overdosing was associated with an increased risk of bleeding requiring hospitalization (adjusted hazard ratio, 3.045; 95% CI, 1.501–6.178; P =.002) and Bleeding Academic Research Consortium type 2 or more (adjusted hazard ratio, 2.196; 95% CI, 1.083–4.452; P =.029). Conclusion: Prescribers’ compliance to approved indications were high. However, 1/3 of DOAC prescriptions were inconsistent with approved dosing. Dosing deviation was associated with an increase in adverse clinical outcomes. | en_US |
dc.subject | Medicine | en_US |
dc.subject | Pharmacology, Toxicology and Pharmaceutics | en_US |
dc.title | Prescriber compliance to direct oral anticoagulant labels and impact on outcomes in Thailand | en_US |
dc.type | Journal | en_US |
article.title.sourcetitle | British Journal of Clinical Pharmacology | en_US |
article.stream.affiliations | Thammasat University Hospital | en_US |
article.stream.affiliations | Liverpool Heart and Chest Hospital | en_US |
article.stream.affiliations | The University of Utah | en_US |
article.stream.affiliations | Police General Hospital | en_US |
article.stream.affiliations | Faculty of Medicine, Ramathibodi Hospital, Mahidol University | en_US |
article.stream.affiliations | Mahidol University | en_US |
article.stream.affiliations | Faculty of Medicine, Siriraj Hospital, Mahidol University | en_US |
article.stream.affiliations | Chiang Mai University | en_US |
article.stream.affiliations | Srinakharinwirot University | en_US |
Appears in Collections: | CMUL: Journal Articles |
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