Article Impact Level: HIGH Data Quality: STRONG Summary of Scientific Reports https://doi.org/10.1038/s41598-025-07712-0 Dr. Bader M. Alghamdi et al.
Points
- This study assessed the appropriateness of direct oral anticoagulant use and dosing in an outpatient underserved clinic.
- Inappropriate dosing based on renal function occurred in 16% of cases among the 125 patients included in the study.
- Two patients with severe hepatic impairment were found to have unsuitable direct oral anticoagulant use.
- Major drug interactions led to inappropriate direct oral anticoagulant use in two instances within the patient cohort.
- Approximately 61% of aspirin usage involved inappropriate combinations with direct oral anticoagulants in this study.
Summary
A cross-sectional study was conducted at the Texas A&M Health Family Care Clinic from December 24, 2022, to December 24, 2023, to evaluate gaps in direct oral anticoagulant (DOAC) management among an outpatient underserved population. The study included 125 patients over 18 years of age with active prescriptions for apixaban, dabigatran, edoxaban, or rivaroxaban. The primary objective was to assess the appropriateness of DOAC use and dosing according to FDA guidelines, considering renal function, hepatic function, and potential drug-drug interactions.
The findings revealed several areas for optimization in DOAC management. Inappropriate dosing based on renal function was observed in 16% of the cases. Additionally, DOAC use was deemed unsuitable in two patients due to severe hepatic impairment. Major drug-drug interactions contributed to two instances of inappropriate DOAC use, highlighting the need for careful medication reconciliation.
A significant secondary finding was the high rate of inappropriate aspirin use concurrently with DOACs, occurring in approximately 61% of cases. These results underscore the potential for adverse outcomes in underserved clinics due to challenges such as incorrect dosing, inadequate monitoring, and improper drug combinations, emphasizing the importance of optimizing anticoagulation management to enhance patient safety and clinical outcomes.
Link to the article: https://www.nature.com/articles/s41598-025-07712-0
References
Alghamdi, B. M., & Rogers, S. L. (2025). Evaluation of gaps in direct oral anticoagulants (Doacs) management in an outpatient underserved clinic: A cross-sectional study. Scientific Reports, 15(1), 23064. https://doi.org/10.1038/s41598-025-07712-0
