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논문검색

Original Article

비판막성 심방세동 환자의 뇌졸중 예방에서 dabigatran과 rivaroxaban의 임상적용의 현황

원문정보

Practice Preferences on Dabigatran and Rivaroxaban for Stroke Prevention in Patients with Non-valvular Atrial Fibrillation

박유경, 강지은, 김승준, 라현오, 이정연

피인용수 : 0(자료제공 : 네이버학술정보)

초록

영어

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ≥ 3 (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

목차

ABSTRACT
 INTRODUCTION
 METHODS
  Patients and setting
  Drug use and prescribing preferences
  Compliance
  Adverse drug reactions
  Prescription reimbursement
  Statistical analysis
 RESULTS
  Patients’ demographics and characteristics
  Drug use evaluation and prescription preferences
  Adverse drug reactions
  Prescription reimbursement
 DISCUSSION
 CONCLUSION
 FUNDING
 CONFLICT OF INTEREST
 ACKNOWLEDGEMENT
 REFERENCES

저자정보

  • 박유경 You Kyung Park. 서울성모병원 약제부, 이화여자대학교 임상보건과학대학원
  • 강지은 Ji Eun Kang. 이화여자대학교 약학대학 생명약학부
  • 김승준 Seong Joon Kim. 알바니 약학대학
  • 라현오 Hyen O La. 가톨릭대학교 의과대학
  • 이정연 Sandy Jeong Rhie. 이화여자대학교 임상보건과학대학원, 이화여자대학교 약학대학 생명약학부

참고문헌

자료제공 : 네이버학술정보
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