Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University Pharmacy, Brooklyn, NY, USA.
Brookdale University Hospital and Medical Center, Brooklyn, NY, USA.
J Pharm Pract. 2020 Apr;33(2):136-141. doi: 10.1177/0897190018788264. Epub 2018 Jul 13.
The aim of this study is to assess patterns of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in an inpatient hospital setting.
A retrospective chart review was conducted at the Brookdale University Hospital and Medical Center (BUHMC) from January 2014 to November 2016. All adult patients admitted to the BUHMC who were treated with a DOAC for at least 3 days were screened. Among them, those who received selected interacting drugs at any time during the course of DOAC therapy were included in this study.
This study included 165 patients with an average of 73 years (standard deviation [SD] = 12.3) and 233 cases. The most commonly used concomitant drug with a DOAC was aspirin (58%), followed by amiodarone (16%) and P2Y inhibitors (11%). The combined use of dual antiplatelet therapy and a DOAC was identified in 18 (6%) cases. Approximately one-third of the cases encountered were classified as the "avoidance" category.
Despite computerized DDI alerts, potentially significant DDIs with DOACs still occur. While the present study provides insight into the current patterns of DDIs, further studies are needed to evaluate clinical outcomes of the potential DDIs with DOACs in practice.
本研究旨在评估直接口服抗凝剂（DOACs）在住院环境中的潜在药物相互作用（DDIs）模式。
本研究回顾性分析了 2014 年 1 月至 2016 年 11 月布鲁克代尔大学医院和医疗中心（BUHMC）的病历。筛选出在 BUHMC 住院且接受 DOAC 治疗至少 3 天的所有成年患者。在此期间，对接受任何时间点 DOAC 治疗时同时使用了选定的相互作用药物的患者进行纳入本研究。
本研究共纳入 165 例患者，平均年龄为 73 岁（标准差 [SD] = 12.3），共纳入 233 例患者。与 DOAC 联合使用最常见的药物是阿司匹林（58%），其次是胺碘酮（16%）和 P2Y 抑制剂（11%）。有 18 例（6%）患者同时接受双联抗血小板治疗和 DOAC 治疗。大约三分之一的病例被归类为“避免”类别。
尽管有计算机化的 DDI 警报，但仍会发生潜在的与 DOACs 相关的显著 DDI。虽然本研究提供了目前 DDI 模式的见解，但仍需要进一步研究来评估实际应用中 DOACs 潜在 DDI 的临床结果。
