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Exploring indications for the Use of direct oral anticoagulants and the associated risks of major bleeding.
Abstract Thrombosis is a leading cause of morbidity and mortality in the United States. Arterial and venous thromboses are implicated in the pathogenesis of major disorders, including myocardial infarction, ischemic stroke, and venous thromboembolism. Over the past decade, direct oral anticoagulants (DOACs) (eg, direct thrombin inhibitor and factor Xa [FXa] inhibitors) have been adopted as alternatives to warfarin due to their clinical advantages and efficacy for the treatment of thrombosis. As with all anticoagulants, treatment with DOACs is associated with a risk of major bleeding, including life-threatening gas...
Source: The American Journal of Managed Care - April 1, 2017 Category: Health Management Authors: Milling TJ, Frontera J Tags: Am J Manag Care Source Type: research

Oral anticoagulant discontinuation in patients with nonvalvular atrial fibrillation.
CONCLUSIONS: The risk of independent discontinuation of OAC treatment among NVAF patients was high. Patients on DOACs compared with warfarin and those with several comorbid conditions had significantly lower risk of discontinuation, while those with prior bleeding were more likely to discontinue. PMID: 26799200 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - January 23, 2016 Category: Health Management Authors: Kachroo S, Hamilton M, Liu X, Pan X, Brixner D, Marrouche N, Biskupiak J Tags: Am J Manag Care Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research

Bleeding as an Outcome Among Patients With Nonvalvular Atrial Fibrillation in a Large Managed Care Population.
CONCLUSIONS: Bleeding incidence among patients with NVAF in a real-world setting was high and increased with greater stroke and bleeding risk scores. Health care costs for patients with major bleeding events were elevated. All rights reserved. PMID: 24075151 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - September 25, 2013 Category: Drugs & Pharmacology Authors: Deitelzweig SB, Pinsky B, Buysman E, Lacey M, Makenbaeva D, Wiederkehr D, Graham J Tags: Clin Ther Source Type: research

Warfarin Use and Stroke Risk Among Patients With Nonvalvular Atrial Fibrillation in a Large Managed Care Population.
CONCLUSIONS: More than half of patients on warfarin had treatment gaps or discontinued therapy. Therapy gaps were associated with increased stroke risk. PMID: 23867114 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - July 15, 2013 Category: Drugs & Pharmacology Authors: Deitelzweig SB, Buysman E, Pinsky B, Lacey M, Jing Y, Wiederkehr D, Graham J Tags: Clin Ther Source Type: research