A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran

Background: Direct oral anticoagulants (DOACs) especially dabigatran, have gain popularity for their efficacy, fixed dosing and favourable safety profile. A dabigatran prescribing checklist has been prepared by the Ministry of Health, Malaysia (MOH) to ensure rational and safe prescribing of dabiga...

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Main Authors: Devaraj, Navin Kumar, George, Doris, Mohamad, Noraini, Rahmat, Shakirin Shaik, Mohamed, Sahimi
Format: Article
Language:English
Published: Malaysian Medical Association 2019
Online Access:http://psasir.upm.edu.my/id/eprint/80431/
http://psasir.upm.edu.my/id/eprint/80431/1/AUDIT.pdf
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author Devaraj, Navin Kumar
George, Doris
Mohamad, Noraini
Rahmat, Shakirin Shaik
Mohamed, Sahimi
author_facet Devaraj, Navin Kumar
George, Doris
Mohamad, Noraini
Rahmat, Shakirin Shaik
Mohamed, Sahimi
author_sort Devaraj, Navin Kumar
building UPM Institutional Repository
collection Online Access
description Background: Direct oral anticoagulants (DOACs) especially dabigatran, have gain popularity for their efficacy, fixed dosing and favourable safety profile. A dabigatran prescribing checklist has been prepared by the Ministry of Health, Malaysia (MOH) to ensure rational and safe prescribing of dabigatran. This study therefore aimed to audit the utilization and documentation of this checklist and use of dabigatran in the government healthcare facilities. Methods: This is a nationwide retrospective audit on the documentation of Dabigatran Prescribing and Dispensing Checklist for a period of two years from January 2013 till December 2014. Data from these Dabigatran Checklists (indication, dose, duration, renal function and adverse drug reactions encountered) were extracted by the pharmacist at MOH healthcare facilities. Results: A total of 52 out of 56 (92.9%) of MOH facilities complied to usage of checklist at their centres involving a total of 582 patients of which 569 (97.7%) patients were initiated on dabigatran for the approved indications. The recommended dose of dabigatran was used correctly in 501 (99.6%) of patients. Reason for switching to DOACs use was only documented in 76.7% (131/171) of patients. The most common reason for switching from warfarin was poor INR control (n=39), history of bleeding/overwarfarinisation (n=22) and unable to attend regular INR clinic (n=21). There were 75 cases of adverse events reported. The most common adverse event reported were abdominal discomfort (n=10) followed by gum bleeding (n=9) and dizziness (n=5). Conclusions: Compliance to the dabigatran check list was high with 70% of patients prescribed the appropriate dosing.
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spelling upm-804312020-11-10T07:20:51Z http://psasir.upm.edu.my/id/eprint/80431/ A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran Devaraj, Navin Kumar George, Doris Mohamad, Noraini Rahmat, Shakirin Shaik Mohamed, Sahimi Background: Direct oral anticoagulants (DOACs) especially dabigatran, have gain popularity for their efficacy, fixed dosing and favourable safety profile. A dabigatran prescribing checklist has been prepared by the Ministry of Health, Malaysia (MOH) to ensure rational and safe prescribing of dabigatran. This study therefore aimed to audit the utilization and documentation of this checklist and use of dabigatran in the government healthcare facilities. Methods: This is a nationwide retrospective audit on the documentation of Dabigatran Prescribing and Dispensing Checklist for a period of two years from January 2013 till December 2014. Data from these Dabigatran Checklists (indication, dose, duration, renal function and adverse drug reactions encountered) were extracted by the pharmacist at MOH healthcare facilities. Results: A total of 52 out of 56 (92.9%) of MOH facilities complied to usage of checklist at their centres involving a total of 582 patients of which 569 (97.7%) patients were initiated on dabigatran for the approved indications. The recommended dose of dabigatran was used correctly in 501 (99.6%) of patients. Reason for switching to DOACs use was only documented in 76.7% (131/171) of patients. The most common reason for switching from warfarin was poor INR control (n=39), history of bleeding/overwarfarinisation (n=22) and unable to attend regular INR clinic (n=21). There were 75 cases of adverse events reported. The most common adverse event reported were abdominal discomfort (n=10) followed by gum bleeding (n=9) and dizziness (n=5). Conclusions: Compliance to the dabigatran check list was high with 70% of patients prescribed the appropriate dosing. Malaysian Medical Association 2019 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/80431/1/AUDIT.pdf Devaraj, Navin Kumar and George, Doris and Mohamad, Noraini and Rahmat, Shakirin Shaik and Mohamed, Sahimi (2019) A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran. Medical Journal of Malaysia, 74 (5). pp. 425-430. ISSN 0300-5283 http://www.e-mjm.org/2019/v74n5/dabigatran-checklist.pdf
spellingShingle Devaraj, Navin Kumar
George, Doris
Mohamad, Noraini
Rahmat, Shakirin Shaik
Mohamed, Sahimi
A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title_full A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title_fullStr A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title_full_unstemmed A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title_short A national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
title_sort national audit on the utilization and documentation of dabigatran checklist for patients initiated on dabigatran
url http://psasir.upm.edu.my/id/eprint/80431/
http://psasir.upm.edu.my/id/eprint/80431/
http://psasir.upm.edu.my/id/eprint/80431/1/AUDIT.pdf