Timing of Off-Label Dosing of Direct Oral Anticoagulants in Three Large Health Systems.

Document Type

Article

Publication Date

7-30-2024

Publication Title

Thrombosis and haemostasis

Abstract

BACKGROUND:  While direct oral anticoagulants (DOACs) may be viewed as simpler to manage then warfarin, they present their own unique management challenges resulting in frequent off-label dosing. It is unknown to what extent off-label dosing occurs when a patient is started on a DOAC versus later in their treatment.

OBJECTIVES:  We aimed to better characterize when off-label DOAC dosing is occurring and to evaluate the effectiveness of prescribing oversight using a registry-based intervention.

METHODS:  We evaluated data from the Michigan Anticoagulation Quality Improvement Initiative (MAQI

RESULTS:  Among a sample of 789 to 1,022 annual AF patients and 381 to 484 annual VTE patients prescribed a DOAC in the MAQI

CONCLUSION:  This study demonstrates the benefit of DOAC prescribing oversight using a registry-based intervention to monitor for off-label dosing for the entirety of the time period a patient is prescribed DOAC, particularly for patients with AF, as off-label prescribing occurs frequently during the follow-up period.

Volume

Online ahead of print

DOI

10.1055/a-2365-8681.

ISSN

2567-689X

PubMed ID

39009007

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