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Condition: Bleeding
Management: Electronic Health Records (EHR)

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Total 34 results found since Jan 2013.

Effectiveness and safety of oral anticoagulants for non-valvular atrial fibrillation: a population-based cohort study in primary healthcare in Catalonia
Conclusion: Being men, a previous event and DOAC-switch posed a higher risk for all study outcomes. direct oral anticoagulants had a protective effect against cerebral bleeding in comparison to vitamin K antagonists. Adherence to direct oral anticoagulants resulted in lower risk of stroke and cerebral bleeding. We found no differences in the risk of stroke and gastrointestinal bleeding when we compared direct oral anticoagulants vs. vitamin K antagonists.
Source: Frontiers in Pharmacology - September 15, 2023 Category: Drugs & Pharmacology Source Type: research

An interrupted time series study of electronic health record clinical decision support for providers caring for patients with atrial fibrillation at increased stroke risk
CONCLUSION: There was a significant trend of increasing anticoagulation rates during the pre-BPA period, with no significant change in trend during the post-BPA period relative to the pre-BPA period.PMID:37696764 | DOI:10.1093/ajhp/zxad188
Source: American Journal of Health-System Pharmacy : AJHP - September 11, 2023 Category: Drugs & Pharmacology Authors: Andrew J Osterland Marie Yasuda Robert J Widmer Anthony C Colavecchia Tyler Gums Birol Emir Kim Nolen Elizabeth MacLean Paul J Godley Source Type: research

Associations of Apixaban Dose With Safety and Effectiveness Outcomes in Patients With Atrial Fibrillation and Severe Chronic Kidney Disease
CONCLUSIONS: Compared with 2.5 mg, use of 5 mg apixaban was associated with a higher risk of bleeding in patients with atrial fibrillation and severe chronic kidney disease, with no difference in the risk of stroke/systemic embolism or death, supporting the apixaban dosing recommendations on the basis of kidney function by the European Medicines Agency, which differ from those issued by the US Food and Drug Administration.PMID:37681341 | DOI:10.1161/CIRCULATIONAHA.123.065614
Source: Circulation - September 8, 2023 Category: Cardiology Authors: Yunwen Xu Alex R Chang Lesley A Inker Mara McAdams-DeMarco Morgan E Grams Jung-Im Shin Source Type: research

Rivaroxaban for Prevention of Thrombotic Events, Hospitalization, and Death in Outpatients With COVID-19: A Randomized Clinical Trial
CONCLUSIONS: The study was terminated prematurely after enrollment of 32% of planned accrual because of recruitment challenges and lower-than-expected event rate. Rivaroxaban prescribed for 35 days in nonhospitalized patients with symptomatic COVID-19 at risk for thrombosis did not appear to reduce a composite end point of venous and arterial thrombotic events, hospitalization, and death.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT04508023.PMID:37154020 | DOI:10.1161/CIRCULATIONAHA.123.063901
Source: Circulation - May 8, 2023 Category: Cardiology Authors: Gregory Piazza Alex C Spyropoulos Judith Hsia Mark Goldin William J Towner Alan S Go Todd M Bull Stephen Weng Concetta Lipardi Elliot S Barnathan Marc P Bonaca PREVENT-HD Investigators Source Type: research

The Impact of Longitudinal Data-Completeness of Electronic Health Record Data on the Prediction Performance of Clinical Risk Scores
Clin Pharmacol Ther. 2023 Apr 7. doi: 10.1002/cpt.2901. Online ahead of print.ABSTRACTThe impact of electronic health record (EHR) discontinuity, i.e., receiving care outside of a given EHR system, on EHR-based risk prediction is unknown. We aimed to assess the impact of EHR-continuity on performance of clinical risk scores. The study cohort consisted of patients aged ≥65 years with ≥1 EHR encounter in the two networks in Massachusetts (MA, 2007/1/1-2017/12/31, internal training and validation dataset), and one network in North Carolina (NC, 2007/1/1-2016/12/31, external validation dataset) that were linked with Medica...
Source: Clinical Pharmacology and Therapeutics - April 7, 2023 Category: Drugs & Pharmacology Authors: Yinzhu Jin Janick G Weberpals Shirley V Wang Rishi J Desai David Merola Kueiyu Joshua Lin Source Type: research

A Real-World Exploration into Clinical Outcomes of Direct Oral Anticoagulant Dosing Regimens in Morbidly Obese Patients Using Data-Driven Approaches
ConclusionData-driven approaches can identify key factors associated with clinical outcomes following the dosing of DOACs in morbidly obese patients. This will help design further studies to explore well tolerated and effective DOAC doses for morbidly obese patients.
Source: American Journal of Cardiovascular Drugs - March 6, 2023 Category: Cardiology Source Type: research

Safety and effectiveness of appropriately and inappropriately dosed rivaroxaban or apixaban versus warfarin in patients with atrial fibrillation: a cohort study with nested case-control analyses from UK primary care
Conclusions Dosing appropriateness in NVAF was not associated with a significant difference in IS/SE risk or increase in ICB risk versus warfarin. These findings may reflect residual confounding and biases that were difficult to control, as also seen in other observational studies. They should, therefore, be interpreted with caution, and prescribers should adhere to the dosing instructions in the respective Summary of Product Characteristics. Further studies on this topic from real-world populations are needed.
Source: BMJ Open - June 2, 2022 Category: General Medicine Authors: Gonzalez-Perez, A., Roberts, L., Vora, P., Saez, M. E., Brobert, G., Fatoba, S., Garcia Rodriguez, L. A. Tags: Open access, Cardiovascular medicine Source Type: research

Appropriateness of inpatient dosing of direct oral anticoagulants for atrial fibrillation
The objective was to determine the rates of inappropriate inpatient DOAC dosing in AF and identifying its associated underlying factors. We conducted a retrospective cross-sectional study from December 2013 to November 2019 across six South Australian public hospitals utilising a centralised electronic health record. Multivariate analysis was used to identify factors associated with underdosing of patients prescribed apixaban. Of 1882 inpatients, 544 (28.9  %) were inappropriately dosed. Underdosing was the most common form of inappropriate dosing with rates of 22.9 % (n = 295), 7.1 % (n = 7), and 25.1 % (n...
Source: Journal of Thrombosis and Thrombolysis - July 24, 2021 Category: Hematology Source Type: research

Atrial fibrillation and oral anticoagulation in older people with frailty: a nationwide primary care electronic health records cohort study
ConclusionAmong older people in England, AF and stroke risk increased with increasing degree of frailty; however, OAC prescription approximated 50%. Given competing demands of mortality, morbidity and stroke prevention, greater attention to stratified stroke prevention is needed for this group of the population.
Source: Age and Ageing - December 16, 2020 Category: Geriatrics Source Type: research