Observational studyEuropean journal of clinical investigation2025
Does hospitalisation improve oral anticoagulant optimisation in patients with atrial fibrillation?
Observational study in European journal of clinical investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hospitalisation as an Opportunity to Optimise Quality Use of Medicines in Older Adults: A Systematic Review.Drugs & aging · 2026Pooled it
- Ten-Year Trend in the Potentially Inappropriate Prescribing of Renally-Dependent Medicines in Australian General Practice Patients with Dementia.Journal of clinical medicine · 2025Article
- Does hospitalisation improve oral anticoagulant optimisation in patients with atrial fibrillation?European journal of clinical investigation · 2025Observational
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Authors and funding
8 authors.
Funding
Abstract
backgroundHospitalisation offers an opportunity for medication review and correction, yet it has received little attention. We aimed to evaluate oral anticoagulant (OAC) use in patients with atrial fibrillation at hospital admission and discharge and determine whether hospitalisation improves care.
methodsWe conducted an observational study at the Royal Hobart Hospital, Australia, in patients with atrial fibrillation. The appropriateness of stroke-prevention therapy at admission and discharge was evaluated using Australian guidelines. Factors associated with correcting inappropriate OAC therapy were identified using multiple logistic regression.
resultsAmong 902 patients, 47.1% (n = 425) were receiving inappropriate OAC therapy at admission. The most common errors included lack of OAC therapy (58.6%, n = 249) and underdosing of direct-acting OACs (15.5%, n = 66). OAC therapy appropriateness at discharge was assessed for 844 patients; 73.8% were receiving appropriate therapy (versus 53.8% at admission (p < .001)). Specifically, 49.0% (n = 191) of the admission therapy errors were corrected. Correction was more likely in patients admitted to the stroke (adjusted odds ratio [aOR]: 16.93, 95% CI: 1.31-218.48) or cardiology wards (aOR: 4.10, 95% CI: 1.94-8.64), and if bleeding occurred during hospitalisation (aOR: 4.01, 95% CI: 1.07-14.99). Conversely, receiving rivaroxaban at admission (aOR: .23, 95% CI: .11-.51) and having a medium or high bleeding risk (ORBIT score ≥3) (aOR: .46, 95% CI: .25-.84) decreased the likelihood of correction.
conclusionHospitalisation improved OAC therapy appropriateness; however, 51.0% of patients admitted with inappropriate therapy continued without correction. An intervention that enhances the hospital care team correcting inappropriate OAC therapy is warranted.
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