Direct Oral Anticoagulant (DOAC) to Warfarin Transitions in a Pharmacist-led Anticoagulation Clinic

A. Woodhouse, M. Burke, A. Misher
{"title":"Direct Oral Anticoagulant (DOAC) to Warfarin Transitions in a Pharmacist-led Anticoagulation Clinic","authors":"A. Woodhouse, M. Burke, A. Misher","doi":"10.37901/jcphp17-00024","DOIUrl":null,"url":null,"abstract":"Purpose\nPatients with non-valvular atrial fibrillation or venous thromboembolism have historically been treated with vitamin-k antagonist therapy; however, due to well-documented limitations, direct oral anticoagulant (DOAC) use has been increasing.(1)(2) The convenience and clinical utility of DOACs is not applicable to all patients, and some must be transitioned to warfarin therapy. Despite practice recommendations, suggestions from package inserts, and clinical trial evidence, there remains a lack of literature describing real-word examples of patient transition from DOACs to warfarin.(3–11)\n\nSummary\nAll patients who were transitioned from a DOAC to warfarin from January to December 2016 and were managed by the clinic were included. Patients were excluded if the transition to warfarin did not include ≥ 2 days of DOAC overlap or if DOAC therapy was used as a bridge to surgery or procedure. St. Joseph's/Candler Health System IRB granted expedited approval and waived informed consent. Four elderly, Caucasian patients met the inclusion criteria. Four patients were successfully transitioned from a DOAC to warfarin for their atrial fibrillation, 3 were transitioned from apixaban and 1 was transitioned from rivaroxaban.\n\nConclusion\nOverall the purpose of this retrospective, observational study was to highlight real-world management of the transition of DOACs to warfarin in an outpatient, pharmacist-led clinic.","PeriodicalId":15502,"journal":{"name":"Journal of Contemporary Pharmacy Practice","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Contemporary Pharmacy Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.37901/jcphp17-00024","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose Patients with non-valvular atrial fibrillation or venous thromboembolism have historically been treated with vitamin-k antagonist therapy; however, due to well-documented limitations, direct oral anticoagulant (DOAC) use has been increasing.(1)(2) The convenience and clinical utility of DOACs is not applicable to all patients, and some must be transitioned to warfarin therapy. Despite practice recommendations, suggestions from package inserts, and clinical trial evidence, there remains a lack of literature describing real-word examples of patient transition from DOACs to warfarin.(3–11) Summary All patients who were transitioned from a DOAC to warfarin from January to December 2016 and were managed by the clinic were included. Patients were excluded if the transition to warfarin did not include ≥ 2 days of DOAC overlap or if DOAC therapy was used as a bridge to surgery or procedure. St. Joseph's/Candler Health System IRB granted expedited approval and waived informed consent. Four elderly, Caucasian patients met the inclusion criteria. Four patients were successfully transitioned from a DOAC to warfarin for their atrial fibrillation, 3 were transitioned from apixaban and 1 was transitioned from rivaroxaban. Conclusion Overall the purpose of this retrospective, observational study was to highlight real-world management of the transition of DOACs to warfarin in an outpatient, pharmacist-led clinic.
药剂师领导的抗凝诊所中直接口服抗凝剂(DOAC)到华法林的转变
目的:非瓣膜性房颤或静脉血栓栓塞患者历来采用维生素k拮抗剂治疗;然而,由于证据充分的局限性,直接口服抗凝剂(DOAC)的使用越来越多。(1)(2)DOAC的便利性和临床实用性并不适用于所有患者,有些患者必须过渡到华法林治疗。尽管有实践建议、说明书建议和临床试验证据,但仍然缺乏文献描述患者从DOAC过渡到华法林的真实例子。(3-11)总结:2016年1月至12月期间由诊所管理的所有从DOAC过渡到华法林的患者。如果过渡到华法林不包括DOAC重叠≥2天,或者DOAC治疗被用作手术或手术的桥梁,则排除患者。圣约瑟夫/坎德勒卫生系统内部审查委员会加快批准并放弃知情同意。4例老年白种人患者符合纳入标准。4例房颤患者成功地从DOAC过渡到华法林,3例从阿哌沙班过渡,1例从利伐沙班过渡。结论:总的来说,这项回顾性观察性研究的目的是强调在门诊、药剂师主导的诊所中,doac向华法林过渡的现实管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
审稿时长
15 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信