Direct oral anticoagulant medication incidents
Canadian Pharmacists Conference ePoster Library. Ho C. Jun 25, 2016; 132152
Dr. Certina Ho
Dr. Certina Ho
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Abstract
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OBJECTIVES: Direct oral anticoagulation utilizing Apixaban, Dabigatran and Rivaroxaban has become highly prevalent due to their ease-of-use and convenient monitoring parameters. Though their unique pharmacologic properties make them a popular choice amongst healthcare professionals, increasing use has also led to an increase in medication incidents involving these medications. This multi-incident analysis serves to explore themes that contribute to incidents involving direct oral anticoagulation medications in the community setting.,METHODS: Incidents were extracted from the Community Pharmacy Incident Reporting (CPhIR) Program between January 2010 and April 2015. A total of 145 incidents met the initial search criteria with 36 being excluded due to insufficient narrative descriptions. The remaining 109 incidents were then analyzed.,RESULTS: Qualitative, multi-incident analysis found a total of five major themes underlying all medication incidents involving direct oral anticoagulants. These included look-alike/sound-alike medications, drug-drug interactions, transition of care, intricacies of anticoagulant dosing/frequency, and pharmacy operation. Although the primary focus of the analysis was on medication incidents in the community, transition of care presented a unique challenge as it referred to medication incidents that occurred when patients were transitioning from a different healthcare setting into the community setting. Numerous contributing factors such as confirmation bias, a lack of reliable Computerized Decision Support Systems, and knowledge deficit of health care practitioners all played a role in facilitating these medication incidents.,CONCLUSIONS: The expanding role of direct oral anticoagulants in conventional chronic drug therapy requires increased vigilance from healthcare professionals. In the community setting, long-term use of direct oral anticoagulants can place the patient at risk of harm if not managed and monitored appropriately. By developing safe medication practices, pharmacists can help educate patients and prevent anticoagulant medication incidents.
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