Trends and Current Status of Oral Anticoagulant Use in Hospitalized Patients in China
SONGJin1, YINGMiao-fa2, YUZhen-wei2*, YULing-yan3
1. Xiasha Division, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China; 2. Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China; 3. Department of Pharmacy, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310012, China
Abstract��OBJECTIVE To investigate the trends and current status of oral anticoagulant (OAC) use in hospitalized patients. METHODS OAC prescriptions of inpatients during 2012 to 2016 were extracted from the database of hospital prescription analysis cooperation program. The extracted prescriptions were restricted to hospitals which located in 5 major cities of China. The number of patients and cost of drugs were calculated and analyzed. RESULTS A total of 258 276 prescriptions were extracted. The number of patients using OAC increased every year. Warfarin was the most frequently prescribed OAC, but the portion of warfarin decreased. Non vitamin-K antagonist anticoagulants (NOAC) including rivaroxaban increased rapidly. Imbalance existed between warfarin and NOAC on patient population and cost. The use of OAC differed by indications and specialists. CONCLUSION The number of patients and cost of drugs increased every year while NOAC had taken a large portion of cost. Attention should be payed to the rationality of OAC use.
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SONGJin, YINGMiao-fa, YUZhen-wei, YULing-yan. Trends and Current Status of Oral Anticoagulant Use in Hospitalized Patients in China. Chinese Pharmaceutical Journal, 2019, 54(8): 671-675.
CHAMBERLAIN A M, GERSH B J, ALONSO A, et al. Decade-long trends in atrial fibrillation incidence and survival: a community study[J]. Am J Med, 2015, 128(3):260-267.
[2]
MORILLO R, JIMÉNEZ D, AIBAR M Á, et al. DVT Management and outcome trends, 2001 to 2014[J]. Chest, 2016,150(2):374-383.
[3]
SURI R M, THOURANI V H, HE X, et al. Variation in warfarin thromboprophylaxis after mitral valve repair: does equipoise exist and is a randomized trial warranted?[J]. Ann Thorac Surg, 2013,95(6):1991-1998.
[4]
PATEL M R, MAHAFFEY K W, GARG J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation[J]. N Engl J Med, 2011,365(10):883-891.
[5]
AGNELLI G, BULLER H R, COHEN A, et al. Apixaban for extended treatment of venous thromboembolism[J]. N Engl J Med, 2013,368(8):699-708.
[6]
GOLDHABER S Z, SCHELLONG S, KAKKAR A, et al. Treatment of acute pulmonary embolism with dabigatran versus warfarin: a pooled analysis of data from RE-COVER and RE-COVER II[J]. Thromb Haemost, 2016,116(4):714-721.
[7]
CLAXTON L, TAYLOR M, LEWIS L, et al. Cost-effectiveness of edoxaban compared with other licensed noacs for the prevention of stroke and systemic embolic events in the UK[J]. Value Heal, 2015,18(7):A396.
[8]
KREJCZY M, HARENBERG J, MARX S, et al.Comparison of cost-effectiveness of anticoagulation with dabigatran, rivaroxaban and apixaban in patients with non-valvular atrial fibrillation across countries[J]. J Thromb Thrombolysis,2014,37(4): 507-523.
[9]
BARNES G D, LUCAS E, ALEXANDER G C, et al. National trends in ambulatory oral anticoagulant use[J]. Am J Med, 2015, 128(12):1300-1305.
[10]
WEITZ J I, SEMCHUK W, TURPIE A G G, et al. Trends in prescribing oral anticoagulantsin canada, 2008-2014[J]. Clin Ther, 2015, 37(11):2506-2514.
[11]
VERDECCHIA P, ANGELI F, AITA A, et al. Why switch from warfarin to NOACs?[J].Intern Emerg Med, 2016, 11(3):289-293.
[12]
TRUSLER M. Well-managed warfarin is superior to NOACs[J]. Can Fam Physician, 2015, 61(1):23-24.
[13]
CONNOLLY S J, EZEKOWITZ M D, YUSUF S, et al. Dabigatran versus warfarin in patients with atrial fibrillation[J]. N Engl J Med, 2009, 361(12):1139-1151.
[14]
GRANGER C B, ALEXANDER J H, MCMURRAY J J V, et al. Apixaban versus warfarin in patients with atrial fibrillation[J]. N Engl J Med, 2011, 365(11):981-992.
[15]
FALCK-YTTER Y, FRANCIS C W, JOHANSON N A, et al. Prevention of VTE in orthopedic surgery patients. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest, 2012, 141(2 suppl):e278S-e325S.
[16]
KEARON C, AKL E A, ORNELA S J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report[J]. Chest, 2016, 149(2):315-352.
[17]
DAULT R, VANASSE A, BLAIS L, et al. Patterns and predictors of use of anticoagulants for the treatment of venous thromboembolism following approval of rivaroxaban[J]. Clin Appl Thromb Hemost, 2016, 22(8):765-771.
[18]
DI PASQUALE G, ZAGNONI S, RIVA L. Novel oral anticoagulants and valvular atrial fibrillation: are they always contraindicated?[J] Intern Emerg Med, 2015, 10(1):21-24.