Drug Use Review of Non-Vitamin K Antagonist Oral Anticoagulants at Fort Sunpasitthiprasong Hospital

Abstract

The prescribing rate of NOACs has been increasing in recent years. Each agent has distinct prescribing considerations, which may pose a risk for inappropriate use. Therefore, it is essential to implement monitoring and oversight of their utilization. Objective: To review the prescription patterns of NOACs at Fort Sunpasitthiprasong Hospital. Methods: A retrospective, cross-sectional study was conducted using the hospital database between January 1 and December 31, 2022. The study assessed the conformity of prescriptions with prescribing criteria regarding indications, dosage, administration, and concomitant use with drugs that potentially harmful drug interactions. Results: Among 764 prescriptions from 127 patients, 66.93% were male with a mean age of 75.55 ± 10.08 years. Common comorbidities were hypertension (74.02%). Based on the diagnosis, 96.47% of prescriptions were for atrial fibrillation, Dabigatran and rivaroxaban accounted for 60.86% and 39.14% of all prescriptions, respectively. For the results of the drug use review, it was found that only 43.98% of the prescriptions conformed to all prescribing criteria. However, when considered separately by indications, dosage, and administration, conformity rates increased to 98.28%, 77.62%, and 53.53%, respectively. None of the prescriptions were found to have severe drug interaction. Conclusion: The prescribing of NOACs was found to be largely appropriate with respect to indications. However, there remains a need for improvement in aspects related to the method of administration and dosage to ensure more optimal prescribing practices within the hospital.