DIRECT ORAL ANTICOAGULANTS ADJUSTMENT TO RENAL FUNCTION IN ATRIAL FIBRILLATION AND ATRIAL FLUTTER

Authors

  • Mariana Pereira Médica Interna de Medicina Geral e Familiar. Unidade de Saúde Familiar Vista Tejo, Agrupamentos de Centros de Saúde Almada Seixal. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal.
  • Nuno Caires Médico Interno de Medicina Geral e Familiar. Unidade de Saúde Familiar Fernão Ferro Mais, Agrupamentos de Centros de Saúde Almada Seixal. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
  • Maria Beatriz Morgado Médica Interna de Medicina Geral e Familiar. Unidade de Saúde Familiar Cova da Piedade, Agrupamentos de Centros de Saúde Almada Seixal. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
  • Rita L. Silva Médica Interna de Medicina Geral e Familiar. Unidade de Saúde Familiar São João do Pragal, Agrupamentos de Centros de Saúde Almada Seixal. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal
  • Catarina Capella Médica Interna de Medicina Geral e Familiar. Unidade de Saúde Familiar Almada, Agrupamentos de Centros de Saúde Almada Seixal. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. Portugal

DOI:

https://doi.org/10.58043/rphrc.55

Keywords:

Anticoagulants, glomerular filtration Rate, atrial fibrillation, atrial flutte

Abstract

Introduction: Atrial fibrillation and flutter are prevalent conditions. Direct oral anticoagulants require dose adjustment to glomerular filtration rate. The objective of this study was to assess the quality of prescription of direct oral anticoagulants in adults with these pathologies.

Methods: We conducted an observational study in 5 Portuguese health care centers. We included adults with atrial fibrillation or flutter, a glomerular filtration rate under 50 mL/min, treated with direct oral anticoagulants and with updated weight and creatinine between june 2020 and may 2021. Glomerular filtration rate was calculated using Cockcroft-Gault formula and direct oral anticoagulants’ prescription adequacy was confirmed according to the summary of product characteristics. A descriptive analysis of the population was made. A correlation between prescription adequacy and patient characteristics, as well as the prescribed direct oral anticoagulant was assessed.

Results: From 95 adults, 43 (45,3%) were male, with an average age of 83 years. 46 (48,4%) presented with inadequate anticoagulant prescription, from whom, 43 (45,3%) had an incorrect dosage and 3 (3,2%) had a formal contraindication to the treatment. We found no association between prescription adequacy, sociodemographic characteristics or the prescribed direct oral anticoagulant.

Discussion: This study suggests that there is an important prevalence of inappropriate prescription of direct oral anticoagulant in patients with reduced glomerular filtration rate in primary health care, compromising the efficacy and safety of this medication. The glomerular filtration rate vigilance is necessary for a correct prescription of direct oral anticoagulants in patients with atrial fibrillation and flutter.

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References

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Published

2023-02-01

How to Cite

1.
Pereira M, Caires N, Morgado MB, L. Silva R, Capella C. DIRECT ORAL ANTICOAGULANTS ADJUSTMENT TO RENAL FUNCTION IN ATRIAL FIBRILLATION AND ATRIAL FLUTTER. RH [Internet]. 2023 Feb. 1 [cited 2024 Nov. 21];(93):30-7. Available from: https://revistahipertensao.pt/index.php/rh/article/view/55

Issue

No. 93 (2023): January/February

Section

Artigo Original

License

Copyright (c) 2023 Mariana Pereira, Nuno Caires, Maria Beatriz Morgado, Rita L. Silva, Catarina Capella

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.