1. Physician perceptions and use of reduced‐dose direct oral anticoagulants for extended phase venous thromboembolism treatment
- Author
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Danielle Groat, Karlyn A. Martin, Rachel P. Rosovsky, Kristen M. Sanfilippo, Manila Gaddh, Lisa Baumann Kreuziger, M. Elaine Eyster, Scott C. Woller, and for the Venous thromboEmbolism Network US (VENUS) VTE Treatment, Anticoagulation Management Group
- Subjects
anticoagulant ,apixaban ,reduced‐dose ,rivaroxaban ,treatment ,venous thromboembolism ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Abstract Background The direct oral anticoagulants (DOACs), apixaban and rivaroxaban, have been studied for extended‐phase treatment of venous thromboembolism (VTE). Yet, scant evidence exists surrounding clinician practice and decision‐making regarding dose reduction. Aims Report clinician practice and characteristics surrounding dose reduction of DOACs for extended‐phase VTE treatment. Methods We conducted a 16‐question REDCap survey between July 14, 2021, and September 13, 2021, among ISTH 2021 Congress attendees and on Twitter. We explored factors associated with dose reduction using logistic regression. We used k‐means clustering to identify distinct groups of dose‐reduction decision‐making. Random forest analysis explored demographics with respect to identified groups. Results Among 171 respondents, most were attending academic physicians from North America. Clinicians who treated larger volumes of patients had higher odds of dose reduction. We identified five clusters that showed distinct patterns of behavior regarding dose reduction. Cluster 1 rarely dose reduces and likely prescribes rivaroxaban over apixaban; cluster 2 dose reduces frequently, does not consider age when dose‐reducing, is least likely to temporarily reescalate dosing, and prescribes apixaban and rivaroxaban equally; cluster 3 dose reduces
- Published
- 2022
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