Evidence map›Paper›PMID 41572210›Full record

ArticleBMC geriatrics2026

Healthcare professionals' perspectives on prescribing DOACs to frail older patients; the DOAC-FRAIL questionnaire.

M J de Jong, A D H Brys, D Braeken, R Pisters, D J A Janssen, S Altintas, S H M Robben, S Nicolaï, C Eurlings, A Zwietering and 8 more

Abstract read
In one paragraph

Article in BMC geriatrics, 2026. 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
–field-weighted citation impact
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. Review
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

18 authors.

M J de JongDepartment of Internal Medicine, Section of Vascular Medicine, Thrombosis Expert Center Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands. Melanie.de.jong@mumc.nl.
A D H BrysDepartment of Geriatrics, Ghent University Hospital, Ghent, Belgium.
D BraekenDepartment of Internal Medicine, Section of Vascular Medicine, Thrombosis Expert Center Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands.
R PistersDepartment of Cardiology, Rijnstate, Arnhem, The Netherlands.
D J A JanssenDepartment of Health Services Research, Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life sciences, Maastricht University, Maastricht, The Netherlands.
S AltintasDepartment of Cardiology, AZ Vesialus, Tongeren, Belgium.
S H M RobbenDepartment of Geriatric Medicine, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
S NicolaïGeneral Practitioner, Maastricht, The Netherlands.
C EurlingsDepartment of Cardiology, Laurentius, Roermond, The Netherlands.
A ZwieteringDivision of Geriatric Medicine, Laurentius, Roermond, The Netherlands.
M De JongheAcademic Center of General Medicine, Faculty of Medicine and Dentistry, UCLouvain, Brussels, Belgium.
B VaesDepartment of Public Health and Primary Care, KU Leuven, Louvain, Belgium.
T De BackerDepartment of Cardiology, Ghent University Hospital, Ghent, Belgium.
M GrymonprezDepartment of Cardiology, Ghent University Hospital, Ghent, Belgium.
H JoostenDivision of General Medicine, Department of Internal Medicine, Section of Geriatric Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
H Ten CateDepartment of Internal Medicine, Section of Vascular Medicine, Thrombosis Expert Center Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands.
K WinckersDepartment of Internal Medicine, Section of Vascular Medicine, Thrombosis Expert Center Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands.
F J H MagdelijnsCARIM School for Cardiovascular Disease, Maastricht University, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDOACs are increasingly prescribed for atrial fibrillation and venous thromboembolism due to their ease of use and lack of monitoring requirements. Prescribing DOACs to frail older patients remains challenging due to higher bleeding and thrombo-embolic risks, comorbidities, polypharmacy, and underrepresentation in clinical trials. This study explored prescribing behavior of healthcare professionals (HCPs) in this complex clinical context.

methodsAn online questionnaire was distributed to HCPs involved in the care of frail older patients. The survey consisted of 27 items divided into three sections: demographics, factors influencing anticoagulant choice, and DOAC management. Descriptive statistics were used to evaluate outcomes.

results355 HCPs completed the questionnaire. HCPs considered frailty(56.9%), fall risk(47.1%) and cognitive impairment (40.0%) when choosing an anticoagulant. Apixaban was the preferred DOAC(56.6%). 74.9% of HCPs did not measure DOAC plasma levels in clinically stable patients, whereas 62.8% measured DOAC plasma level during acute hospitalizations. A large group of HCPs(46.4%) actively switched from VKA to DOAC, but expressed reservations due to fear for an increased bleeding risk. Almost half(48.1%) of HCPs indicated the need for clearer, tailored guidelines for DOAC use in frail older patients.

conclusionsThis study highlights the complexity of prescribing DOACs to frail older patients. While HCPs take multiple factors into account, a standardized approach to prescribing DOACs in this population remains lacking. In addition, almost half of HCPs expressed a need for guidelines regarding DOAC use in frail older patients. Hence, more research is needed to fill this knowledge gap and guide HCPs in clinical practice.

Indexed as

Attitude of Health PersonnelFactor Xa InhibitorsFrail ElderlyHealth PersonnelPractice Patterns, Physicians'AgedAged, 80 and overAnticoagulantsAtrial FibrillationDrug PrescriptionsFemaleHumansMaleSurveys and QuestionnairesVenous ThromboembolismAnticoagulantsFactor Xa InhibitorsDOACFrailOlder patientsPrescribing behaviorThrombosis

Identifiers

PMID41572210
PMCPMC13032589

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.