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1. Prevalence, Contemporary Trends and Associated Factors of Potentially Inappropriate Prescription of Edoxaban in Real‐world Clinical Practice: A Subanalysis of the SUNSHINE Registry

Author

Zhao, Shujuan, primary, Dai, Hengfen, additional, Chen, Jiaxin, additional, Ni, Ming, additional, Peng, Wenxing, additional, Li, Xiaoyu, additional, Li, Fen, additional, Chen, Boya, additional, Cai, Haixia, additional, Liu, Yinping, additional, Gu, Zhichun, additional, Du, Song, additional, and Ma, Peizhi, additional

Published
2023
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2. Prevalence, contemporary trends and associated factors of potentially inappropriate prescription of edoxaban in real‐world clinical practice: A subanalysis of the SUNSHINE registry.

Author

Zhao, Shujuan, Dai, Hengfen, Chen, Jiaxin, Ni, Ming, Peng, Wenxing, Li, Xiaoyu, Li, Fen, Chen, Boya, Cai, Haixia, Liu, Yinping, Gu, Zhichun, Du, Song, and Ma, Peizhi

Subjects
AMIODARONE, INAPPROPRIATE prescribing (Medicine), EDOXABAN, ORAL medication, OFF-label use (Drugs), CHINESE people
Abstract

Aim: As the direct oral anticoagulant most recently approved in China, data pertaining to clinical edoxaban use are still scarce. This study investigated the prevalence of and contemporary trends in edoxaban prescription among Chinese patients as well as factors associated with its inappropriate use in a multicentre registry of patients treated in real‐world clinical practice. Methods: This real‐world, prospective, multicentre and non‐interventional study included 1005 inpatients treated with edoxaban. According to National Medical Products Administration and European Heart Rhythm Association guidelines, edoxaban therapy was determined to be appropriate or inappropriate in each case. Results: The median patient age was 70.0 years (interquartile range 61.0‐78.0 years) and 46.3% were women. Overall, 456 (45.4%) patients received inappropriate edoxaban therapy, and common issues included an inappropriately low dosage (183, 18.2%) or wrong drug selection (109, 10.8%), high dosage (73, 7.3%), unreasonable off‐label use (49, 4.9%), contraindicated medication combinations (27, 2.7%) and incorrect administration timing (16, 1.6%). Several factors, such as age ≥75 years (odds ratio [OR] = 1.921, 95% confidence interval [CI] 1.355‐2.723, P < 0.001), weight >60 kg (OR = 2.657, 95%CI 1.970‐3.583, P < 0.001), severe renal insufficiency (OR = 1.988, 95% CI 1.043‐3.790, P = 0.037), current anaemia (OR = 1.556, 95% CI 1.151‐2.102, P = 0.004) and history of bleeding (OR = 2.931, 95% CI 1.605‐5.351, P < 0.001) were associated with an increased risk of inappropriate edoxaban therapy, whereas factors associated with cardiovascular specialties, such as admission to a cardiovascular department (OR = 0.637, 95% CI 0.464‐0.873, P = 0.005), dronedarone use (OR = 0.065, 95% CI 0.026‐0.165, P < 0.001) and amiodarone use (OR = 0.365, 95% CI 0.209‐0.637, P < 0.001) decreased this risk. Conclusion: In this real‐world study, 45.4% of patients received an inappropriate treatment with edoxaban. Multiple clinical characteristics can help identify patients who should receive edoxaban. Further development and implantation of educational activities and management strategies are needed to ensure the correct use of edoxaban. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Factors influencing medication knowledge and beliefs on warfarin adherence among patients with atrial fibrillation in China

Author

Zhao,Shujuan, Zhao,Hongwei, Wang,Xianpei, Gao,Chuanyu, Qin,Yuhua, Cai,Haixia, Chen,Boya, Cao,Jingjing, Zhao,Shujuan, Zhao,Hongwei, Wang,Xianpei, Gao,Chuanyu, Qin,Yuhua, Cai,Haixia, Chen,Boya, and Cao,Jingjing

Abstract

Shujuan Zhao,1 Hongwei Zhao,1 Xianpei Wang,2 Chuanyu Gao,2 Yuhua Qin,1 Haixia Cai,1 Boya Chen,1 Jingjing Cao1 1Department of Pharmacy, 2Department of Cardiovascular Medicine, People’s Hospital of Henan Province, Zhengzhou, Henan, People’s Republic of China Objectives: Warfarin is often used for ischemic stroke prevention in patients with atrial fibrillation (AF), but the factors affecting patient adherence to warfarin therapy have not been fully understood. Methods: A cross-sectional survey was conducted in AF patients undergoing warfarin therapy at least 6 months prior to the study. The clinical data collected using questionnaires by phone interviews included the following: 1) self-reported adherence measured by the Morisky Medication Adherence Scale-8©; 2) beliefs about medicines surveyed by Beliefs about Medicines Questionnaire (BMQ); and 3) drug knowledge as measured by the Warfarin Related Knowledge Test (WRKT). Demographic and clinical factors associated with warfarin adherence were identified using a logistic regression model. Results: Two hundred eighty-eight patients completed the survey and 93 (32.3%) of them were classified as nonadherent (Morisky Medication Adherence Scale-8 score <6). Major factors predicting warfarin adherence included age, cardiovascular disorders, WRKT, and BMQ; WRKT and BMQ were independently correlated with adherence to warfarin therapy by multivariate logistic regression analysis. Adherents were more likely to have greater knowledge scores and stronger beliefs in the necessity of their specific medications ([odds ratio {OR} =1.81, 95% confidence interval {CI} =1.51–2.15] and [OR =1.17, 95% CI =1.06–1.29], respectively). Patients with greater concerns about adverse reactions and more negative views of general harm were more likely to be nonadherent ([OR =0.76, 95% CI =0.69–0.84] and [OR =0.82, 95% CI =0.73–0.92], respectively). Conclusion: BMK and WRKT are

Published
2017

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