Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study
Background: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsig...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/11/3568 |
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| author | Woldesellassie M. Bezabhe Luke R. Bereznicki Jan Radford Barbara C. Wimmer Mohammed S. Salahudeen Ivan Bindoff Edward Garrahy Gregory M. Peterson |
| author_facet | Woldesellassie M. Bezabhe Luke R. Bereznicki Jan Radford Barbara C. Wimmer Mohammed S. Salahudeen Ivan Bindoff Edward Garrahy Gregory M. Peterson |
| author_sort | Woldesellassie M. Bezabhe |
| collection | DOAJ |
| description | Background: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsight, over a five-year period. Methods: We performed five sequential cross-sectional analyses in patients with atrial fibrillation (AF) and a recorded DOAC prescription. Patients were defined as having a drug interaction if they had a recorded prescription of an interacting medication while they had had a recorded prescription of DOAC in the previous six months. The sample size for the cross-sectional analyses ranged from 5333 in 2014 to 19,196 in 2018. Results: The proportion of patients who had potential drug interactions with a DOAC decreased from 45.9% (95% confidence interval (CI) 44.6%–47.4%) in 2014 to 39.9% (95% CI 39.2%–40.6%) in 2018, <i>p</i> for trend < 0.001. During this period, the most frequent interacting class of medication recorded as having been prescribed with DOACs was selective serotonin/serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants, followed by non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs) and amiodarone. Conclusions: Overall, potential drug interactions with DOACs have decreased slightly over the last five years; however, the rate of possible interaction with SSRIs/SNRIs has remained relatively unchanged and warrants awareness-raising amongst prescribers. |
| first_indexed | 2024-03-10T15:04:29Z |
| format | Article |
| id | doaj.art-d6d8b9acc0a94a5a81877e4ae7846988 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:04:29Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d6d8b9acc0a94a5a81877e4ae78469882023-11-20T19:56:25ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01911356810.3390/jcm9113568Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide StudyWoldesellassie M. Bezabhe0Luke R. Bereznicki1Jan Radford2Barbara C. Wimmer3Mohammed S. Salahudeen4Ivan Bindoff5Edward Garrahy6Gregory M. Peterson7School of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaLaunceston Clinical School, Tasmanian School of Medicine, University of Tasmania, Launceston 7250, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaLaunceston Clinical School, Tasmanian School of Medicine, University of Tasmania, Launceston 7250, AustraliaSchool of Pharmacy and Pharmacology, University of Tasmania, Private Bag 26, Hobart, Tasmania 7001, AustraliaBackground: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsight, over a five-year period. Methods: We performed five sequential cross-sectional analyses in patients with atrial fibrillation (AF) and a recorded DOAC prescription. Patients were defined as having a drug interaction if they had a recorded prescription of an interacting medication while they had had a recorded prescription of DOAC in the previous six months. The sample size for the cross-sectional analyses ranged from 5333 in 2014 to 19,196 in 2018. Results: The proportion of patients who had potential drug interactions with a DOAC decreased from 45.9% (95% confidence interval (CI) 44.6%–47.4%) in 2014 to 39.9% (95% CI 39.2%–40.6%) in 2018, <i>p</i> for trend < 0.001. During this period, the most frequent interacting class of medication recorded as having been prescribed with DOACs was selective serotonin/serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants, followed by non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs) and amiodarone. Conclusions: Overall, potential drug interactions with DOACs have decreased slightly over the last five years; however, the rate of possible interaction with SSRIs/SNRIs has remained relatively unchanged and warrants awareness-raising amongst prescribers.https://www.mdpi.com/2077-0383/9/11/3568atrial fibrillationdirect-acting oral anticoagulantsdrug–drug interactionsprimary care |
| spellingShingle | Woldesellassie M. Bezabhe Luke R. Bereznicki Jan Radford Barbara C. Wimmer Mohammed S. Salahudeen Ivan Bindoff Edward Garrahy Gregory M. Peterson Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study Journal of Clinical Medicine atrial fibrillation direct-acting oral anticoagulants drug–drug interactions primary care |
| title | Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study |
| title_full | Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study |
| title_fullStr | Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study |
| title_full_unstemmed | Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study |
| title_short | Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study |
| title_sort | five year trends in potential drug interactions with direct acting oral anticoagulants in patients with atrial fibrillation an australian wide study |
| topic | atrial fibrillation direct-acting oral anticoagulants drug–drug interactions primary care |
| url | https://www.mdpi.com/2077-0383/9/11/3568 |
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