Trial reportResearch and practice in thrombosis and haemostasis2026
Clinical decision support tool evaluation: Correction of direct oral anticoagulant dosing errors by clinical pharmacists and physicians.
Trial report in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Background: Inappropriate dosing occurs in up to 20% of direct oral anticoagulant (DOAC) prescriptions and is associated with bleeding, hospitalization, and death. Understanding why DOAC dosing errors arise after the initial prescribing period and how clinicians decide to adjust doses may help improve future antithrombotic stewardship efforts. Objectives: This study aimed to describe responses by clinicians to asynchronous electronic health record notifications regarding inappropriate DOAC prescriptions that develop after the initial prescribing period. Methods: As part of a larger randomized trial to improve evidence-based DOAC prescribing, we conducted a manual chart review to assess reasons for inappropriate DOAC prescriptions, clinician response, and reasons for not changing DOAC prescriptions. Results: Most apixaban prescribing errors occurred in patients aged 80 years or older (87.8%). Overall, dose changes occurred after 32.7% of notifications. Notifications to increase the dose of apixaban resulted in fewer dose changes (16.8%) than those to reduce the dose of apixaban (52%), increase the dose of rivaroxaban (43.2%), or decrease the dose of rivaroxaban (43.6%). The original DOAC prescribers were less likely than pharmacists to document a reason for not making a dose change (46.1% vs 90.5%). Renal function, weight, and bleeding-related reasons were commonly cited as reasons not to make a dose change. Conclusion: Various patient factors differentially influenced the likelihood that a clinician would change an inappropriate DOAC prescription. These factors can be used to tailor electronic health record-based notifications to reduce the burden on prescribers while maximizing the impact on patient safety by increasing evidence-based prescribing.
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