WEDNESDAY, Sept. 25, 2024 (HealthDay News) — Early adoption of the direct oral anticoagulant (DOAC) population management dashboard, the purpose of which includes pharmacist review and correction of off-label dosing prescriptions, is associated with reduced rates of off-label DOAC dosing prescription and reduced bleeding, according to a study published online Sept. 9 in the Journal of the American Heart Association.
Geoffrey D. Barnes, M.D., from the Frankel Cardiovascular Center at the University of Michigan in Ann Arbor, and colleagues identified all patients prescribed DOACs for atrial fibrillation or venous thromboembolism between August 2015 and December 2019 using data from the Veterans Health Affairs. Effectiveness, defined as the monthly rate of off-label DOAC prescribing and the rate of clinical adverse events, was examined in association with rollout of the DOAC population management dashboard.
The researchers found that between 6.9 and 8.6 percent of the 128,652 patients receiving DOAC therapy at 123 centers had off-label DOAC prescriptions. A decline in off-label dosing prescriptions (8.7 to 7.6 percent) was seen in association with adoption of the DOAC population management tool dashboard before July 2018. Following implementation, only one group demonstrated a significant reduction in monthly rates of bleeding. Following dashboard adoption, all sites experienced a reduction in the composite of venous thromboembolism or stroke. No difference in the implementation outcome of DOAC prescription change within seven days was seen in any of the adoption groups.
“This analysis provides evidence that most of the DOAC population management tool dashboard’s three main purposes were likely successful and strongly support this approach to antithrombotic stewardship,” the authors write.
Two authors disclosed ties to the pharmaceutical industry.
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