A scoping review of factors associated with the prescribing choice of direct oral anticoagulant drugs.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2025-07-25 DOI:10.1080/14779072.2025.2536043

Hanan Abunimeh, Solafa NoorSaeed, Rahaf Alkhlaifat, Amanj Kurdi, Tanja Mueller

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引用次数: 0

Abstract

Introduction: With the substantial increase in direct oral anticoagulant (DOAC) usage, prescribers face complex decisions regarding the appropriate agent selection. This scoping review aimed to identify factors influencing oral anticoagulant choice in clinical practice over time.

Methods: Four databases (Medline, Embase, Scopus, Web of Science) were searched for quantitative observational studies on patients prescribed DOACs for any indication, focusing on factors affecting OAC choice. Studies published from January 2010 to March 2023 were included.

Results: Of the 4659 identified studies, 60 met selection criteria. Most (96%) examined the choice between DOACs and vitamin K antagonists (VKA); while (15%) evaluated factors affecting choice among DOACs. Age and gender were included in 77% and 70% of studies, respectively. Renal impairment (58%), heart failure (48%), previous stroke (43%), and thromboembolic risk (43%) were also commonly assessed. Older age had a significant negative association with DOAC prescribing in (50%) of the studies; renal impairment reduced DOAC initiation, favoring warfarin in (94%).

Conclusions: Several significant key factors were identified as being associated with OAC choice, including demographic factors such as age, and clinical factors such as kidney function, prior stroke, and other comorbidities. Significant factors in the choice among DOACs were advanced age, and renal impairment.

Registration: This systematic review was registered as a PURE protocol (https://pureportal.strath.ac.uk/en/projects/factors-associated-with-the-prescribing-of-direct-acting-oral-ant).

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与直接口服抗凝药物处方选择相关因素的范围审查。

导论：随着直接口服抗凝剂（DOAC）使用量的大幅增加，处方医师面临着关于适当药物选择的复杂决策。本综述旨在确定临床实践中影响口服抗凝剂选择的因素。方法：检索Medline、Embase、Scopus、Web of Science等4个数据库，对任意适应症患者使用doac进行定量观察研究，重点关注影响OAC选择的因素。纳入了2010年1月至2023年3月发表的研究。结果：4659项研究中，60项符合选择标准。大多数（96%）检查DOACs和维生素K拮抗剂（VKA）之间的选择；而（15%）评估影响doac选择的因素。年龄和性别分别被纳入77%和70%的研究。肾功能损害（58%）、心力衰竭（48%）、既往中风（43%）和血栓栓塞风险（43%）也常被评估。在50%的研究中，年龄较大与DOAC处方呈显著负相关；肾功能损害降低DOAC起始，华法林更有利（94%）。结论：确定了与OAC选择相关的几个重要关键因素，包括人口因素（如年龄）和临床因素（如肾功能、既往卒中和其他合并症）。高龄和肾功能损害是影响DOACs选择的重要因素。注册：本系统评价注册为PURE方案（https://pureportal.strath.ac.uk/en/projects/factors-associated-with-the-prescribing-of-direct-acting-oral-ant）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.