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Trends in oral anticoagulant use - A 10-year retrospective analysis from a general medicine department of a tertiary care hospital in south India.
- Source :
-
Journal of postgraduate medicine [J Postgrad Med] 2024 Apr 01; Vol. 70 (2), pp. 77-83. Date of Electronic Publication: 2023 Jul 19. - Publication Year :
- 2024
-
Abstract
- Background: The prescribing practice of newer oral anticoagulants (NOACs) has not been adequately studied in the Indian scenario.<br />Aims: We aimed to describe the prescribing practices of oral anticoagulants, the patient profile and medical comorbidities among patients admitted in a general medicine unit.<br />Methods: In this retrospective study of the 2742 patients prescribed vitamin- K antagonists (VKAs), during the study period, 150 cases were randomly taken for analysis to match the 105 NOACs cases. Their demographic details, clinical characteristics and treatment details were analyzed.<br />Results: More than 95% of anticoagulants prescribed were VKAs. The prescription of anticoagulants was more common in men (median age 63 years) for prescription of NOACs and 52 years for VKAs. Dabigatran (60.9%) and warfarin (81.3%) were the most prescribed drugs in their respective classes. The most common indication was for cardiovascular diseases with atrial fibrillation (32%). Diabetes and hypertension were the most common comorbidities in patients prescribed oral anticoagulants with a larger proportion of patients with heart failure being prescribed VKAs ( P < 0.01). Patients in the NOACs group had a higher HAS-BLED high-risk score (33.3% vs. 17.3%; P = 0.002). Logistic regression analysis revealed that patients with co-morbidities of congestive heart failure were more likely to be prescribed VKAs while diabetics were more likely to receive NOACs.<br />Conclusions: VKAs were the most prescribed anticoagulants; congestive heart failure, diabetes, and hypertension were the commonest comorbidities; and atrial fibrillation was the commonest indication. Patients with a high HAS-BLED score were prescribed NOACs more often.<br /> (Copyright © 2023 Copyright: © 2023 Journal of Postgraduate Medicine.)
- Subjects :
- Humans
Male
Female
India epidemiology
Retrospective Studies
Middle Aged
Administration, Oral
Aged
Atrial Fibrillation drug therapy
Atrial Fibrillation epidemiology
Adult
Practice Patterns, Physicians' trends
Practice Patterns, Physicians' statistics & numerical data
Warfarin therapeutic use
Warfarin administration & dosage
Comorbidity
Vitamin K antagonists & inhibitors
Stroke epidemiology
Dabigatran therapeutic use
Dabigatran administration & dosage
Anticoagulants therapeutic use
Anticoagulants administration & dosage
Tertiary Care Centers
Subjects
Details
- Language :
- English
- ISSN :
- 0972-2823
- Volume :
- 70
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of postgraduate medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37470633
- Full Text :
- https://doi.org/10.4103/jpgm.jpgm_10_23