SciELO - Scientific Electronic Library Online

 
vol.10 issue1Evaluation of the prescription of Metformin in patients with Type 2 Diabetes Mellitus in a Health Primary attention Institution in Cartagena de Indias, Colombia author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista Clínica de Medicina de Familia

On-line version ISSN 2386-8201Print version ISSN 1699-695X

Abstract

MARTINEZ-RUIZ, Marta et al. Use of new oral anticoagulants in primary care: quality of prescription. Rev Clin Med Fam [online]. 2017, vol.10, n.1, pp.18-28. ISSN 2386-8201.

Objective: To assess the quality of prescription of the new oral anticoagulants. To identify posible factors associated with its inappropriate use. Design: Descriptive cross-sectional study. Location: Urban primary healthcare district. Participants: All patients who used new oral anticoagulants (NOAC) during 2015 (153 subjects). Main measurements: Prescription compliance to the recommendations of the Spanish Agency of Medicines and Medical Devices (AEMPS). Other variables: NOAC prescribed (ATC classification), indication and duration of treatment, prescriber, Charlson index, polypharmacy (5 or more drugs), use of healthcare services, and socio-demographic variables. Multivariate analysis to determine possible factors associated with inappropriate use. Results: 145 subjects were included (23.8 % of the total users of oral anticoagulants). Average age 76 years (SD:11.4), 50.3 % were women. Rivaroxaban the most prescribed (41.4 %). Indication and usual prescriber: non-valvular atrial fibrillation - NVAF - (93.1 % of cases) and cardiologists (71.7 %). The median of use was 20 months (interquartile range: 8 to 32). 46.9 % of patients used acenocoumarol, and the usual reason for the change was poor INR control. In 74.1 %(100 cases) (CI 95 %: 65.8 - 81.2) the global use of NOAC, in patients with NVAF, was inappropriate. Variables associated with inappropriate use: not to prescribe NOAC from the beginning (OR: 7.0; CI 95 %: 1.8 - 27.1) and longer duration of anticoagulant therapy (OR: 2.4; CI 95 %: 1.3 - 4.5). Conclusion: In our environment, one of every four prescriptions of new anticoagulants, in patients with NVAF, follows the recommendations of the AEMPS. We must be vigilant against possible risks of this high inappropriate use.

Keywords : Anticoagulants; Prescription; Quality of Healthcare; Primary Health Care.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License