Background For more than 60 years, warfarin has been the mainstay anticoagulation therapy worldwide. Since 2008, direct oral anticoagulants (DOACs) have been introduced to the market which expands the options for healthcare practitioners to find new alternatives to warfarin for the treatment and prevention of atrial fibrillation and thromboembolic events. Domestically, dabigatran was introduced in 2011 followed by rivaroxaban in 2014. The global use of DOACs is increasing, yet we have little knowledge with regard to the adoption of DOACs into local clinical practice.
Purpose This study aimed to explore the local prescribing trends of oral anticoagulants over a 5 year period (from 2011 to 2015). Also, we aimed to explore the switching pattern among anticoagulants, from warfarin to DOACs and vice versa.
Material and methods A time series analysis was conducted using patient electronic medical records of dispensed prescriptions (inpatient or outpatient) from the main medical corporation in the country to assess the use of oral anticoagulants between the period January 2011 until the end of October 2015. For every calendar year, the data obtained were used to quantify the percentage of patients using each agent.
Results 7178 patients used oral anticoagulants over the past 5 years: 6044 (84.2%) used warfarin, 518 (7.2%) used dabigatran and 616 (8.6%) used rivaroxaban. There was a gradual increase in the percentage of patients receiving DOACs from 0.5% in 2011 to 26% in 2015. Similarly, among DOACs users, 261 (22.3%) were previous warfarin users while 188 (16.1%) patients who were using DOACs were switched back to warfarin.
Conclusion A gradual growth in DOACs use has been observed in local practice with a trend similar to other countries. Yet, until today, warfarin remains the most used oral anticoagulant.
References and/or acknowledgements Please note that the country/hospital name has been removed from the abstract title/text. However, the study took place in Qatar and it is a crucial part of the abstract as it is evaluating the practice in Qatar.
No conflict of interest