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Potentially inappropriate prescribing of DOACs to people with mechanical heart valves

We conducted a retrospective cohort study of DOAC prescribing in people with a record of a mechanical heart valve between September 2019 and May 2021, and describe the characteristics of this population.

Thrombosis Research, 2022

NHS England issued guidance for anticoagulant services during the COVID-19 pandemic including advice on the safe switching of patients on warfarin to direct oral anticoagulants (DOACs), where appropriate. As DOACs require less frequent blood testing, this supported the reduction of pressures being experienced by the NHS and the lowering of the risk of virus transmission. We have previously shown that this guidance was followed by increased switching of anticoagulants to DOACs.

OpenSAFELY Collaborative, Fisher L, Speed V, Curtis HJ, Rentsch CT, Wong AYS, Schultze A, Massey J, Inglesby P, Morton CE, Wood M, Walker AJ, Morley J, Mehrkar A, Bacon S, Hickman G, Bates C, Croker R, Evans D, Ward T, Cockburn J, Davy S, Bhaskaran K, Smith B, Williamson E, Hulme W, Green A, Eggo RM, Forbes H, Tazare J, Parry J, Hester F, Harper S, Meadows J, O'Hanlon S, Eavis A, Jarvis R, Avramov D, Griffiths P, Fowles A, Parkes N, Douglas IJ, Evans SJW, Smeeth L, MacKenna B, Tomlinson L, Goldacre B. Potentially inappropriate prescribing of DOACs to people with mechanical heart valves: A federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY. Thromb Res. 2022 Mar;211:150-153. doi: 10.1016/j.thromres.2022.01.023. Epub 2022 Jan 29. PMID: 35168181.