Patterns of direct oral anticoagulant drug prescription in France in 2010–2013: a study in the Midi-Pyrénées area

  • Hugo Diaz
  • Haleh Bagheri
  • Aurore Palmaro
  • Vanessa Rousseau
  • Robert Bourrel
  • Jean-Louis Montastruc
  • Jordan Birebent
Pharmacoepidemiology and Prescription
  • 40 Downloads

Abstract

Aim

The aim of our study was to study the pattern of prescription of direct-acting oral anticoagulants (DOACs) according to the French recommendations.

Methods

We performed a cross-sectional study using anonymous data of patients covered by the French National Health Insurance information system (SNIIRAM) from 1 January 2010 to 31 December 2013 in the area of Midi-Pyrénées (southwest of France).

Results

Of the 355,608 patients identified, 325,216 (91.5%) were included, of whom 22,142 received at least one DOAC. About 39.1% (8,652 patients) had DOAC in an orthopedic indication, 46.5% (10,303 patients) in a cardiac indication, and 16.1% (3568 patients) in an indeterminate indication. Overall, guidelines were largely followed as for renal function monitoring, prescribing in orthopedic indications, in cardiac indications in patients aged 80 years and older, and in the case of concomitant use of verapamil. However, inappropriate prescriptions were observed for cardiac indications, and for dosage adjustments in orthopedic indications, with respect to both the age of patients (75 years and older) and those taking verapamil or amiodarone concomitantly. Guidelines were more followed in women and patients aged 80 or more.

Conclusions

Among patients receiving DOACs, 58% were exposed to a prescription falling outside the guidelines. This study on DOAC prescription patterns revealed insufficiencies in the compliance with the French guidelines in certain indications.

Keywords

Direct oral anticoagulants French guidelines Pattern of prescription 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

228_2018_2449_MOESM1_ESM.docx (27 kb)
ESM 1 (DOCX 27 kb)
228_2018_2449_MOESM2_ESM.docx (31 kb)
ESM 2 (DOCX 31 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Hugo Diaz
    • 1
  • Haleh Bagheri
    • 2
    • 3
  • Aurore Palmaro
    • 2
    • 3
    • 4
    • 5
  • Vanessa Rousseau
    • 2
    • 3
    • 4
  • Robert Bourrel
    • 6
  • Jean-Louis Montastruc
    • 2
  • Jordan Birebent
    • 1
  1. 1.Academic Department of Family Medicine, Faculty of Medicine ToulouseUniversity of ToulouseToulouseFrance
  2. 2.Medical and Clinical Pharmacology UnitCHU Toulouse University HospitalToulouseFrance
  3. 3.Medical and Clinical Pharmacology Unit, CHU Toulouse University Hospital, Pharmacoepidemiology Research Unit, INSERM 1027University of ToulouseToulouseFrance
  4. 4.Pharmacoepidemiology Research Unit, INSERM 1027University of ToulouseToulouseFrance
  5. 5.CIC 1436, Toulouse University HospitalToulouseFrance
  6. 6.Direction du Service médical de l’Assurance maladie (CNAMTS)ToulouseFrance

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