Evidence map›Paper›PMID 32822665›Full record

ArticleThe American journal of medicine2021

Inappropriate Prescription of Direct Oral Anticoagulant Starter Packs.

Yilin Feng, Chih-Wen Pai, Kristian Seiler, Geoffrey D Barnes

Open access · greenAbstract read
In one paragraph

Article in The American journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Yilin FengUniversity of Michigan Medical School, Ann Arbor.
Chih-Wen PaiDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor.
Kristian SeilerInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor.
Geoffrey D BarnesDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor. Electronic address: gbarnes@umich.edu.
University of Michigan · USMichigan Medicine · US

Funding

Improving Safe Use of Direct Oral Anticoagulants: A Population Health ApproachR18HS026874 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARNES, GEOFFREY DOUGLAS · 2020 to 2022
$1.5M
Developing an Implementation Strategy to Improve Peri-procedural Anticoagulation Management for Patients with Atrial FibrillationK01HL135392 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARNES, GEOFFREY DOUGLAS · 2017 to 2021
$842k
AHRQ HHS R18 HS026874NHLBI NIH HHS K01 HL135392
6 · The paper itself

Abstract

backgroundThe 30-day direct oral anticoagulant starter pack has simplified the treatment of acute venous thromboembolisms, but it is not appropriate for use in patients with other indications for anticoagulation.

methodsA retrospective analysis of national outpatient pharmacy claims data between January 1, 2015 and December 31, 2018, was performed. Adult patients (ages >18 years) with continuous insurance enrollment at least 12 months prior to and 1 month following a direct oral anticoagulant starter pack prescription during the study period were included. The primary study outcome was the rate of inappropriate prescription of direct oral anticoagulant starter packs, defined as a prescription without a venous thromboembolism diagnosis within the prior 45 days or a prescription with a prior starter pack fill within the past 45 days.

resultsA total of 3711 direct oral anticoagulant starter pack prescription fills were identified, representing 3634 unique patients. The mean patient age was 62.8 years (standard deviation [SD] 15.1) and 1871 (50.4%) were females. There were 770 (20.7%) direct oral anticoagulant starter pack fills identified as potentially inappropriate. Patients prescribed inappropriate fills were likely to be older than patients with appropriate fills (64.7 years vs 62.4 years, P < 0.001). There was no significant difference in the race or geographic location between patients with inappropriate and appropriate prescriptions.

conclusionsA significant proportion of patients using direct oral anticoagulant starter packs did not have a diagnosis of acute venous thromboembolism, raising concerns about inappropriate prescribing and potential bleeding complications. Future studies are needed to identify factors associated with inappropriate direct oral anticoagulant starter pack prescription and evaluate efforts to reduce this practice.

Indexed as

Acute DiseaseAgedFactor Xa InhibitorsFemaleHumansInappropriate PrescribingMaleMiddle AgedRetrospective StudiesTime FactorsVenous ThromboembolismFactor Xa InhibitorsAnticoagulationAtrial fibrillationPrescriptionStarter packThrombosis

Identifiers

PMID32822665
PMCPMC7889739
OpenAlexW3049182429

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.