The Journal of the American Heart Association recently conducted a study involving 21,878 nursing home residents with nonvalvular atrial fibrillation (NVAF) which revealed that standard doses of direct oral anticoagulants (DOACs) led to a higher rate of bleeding compared to reduced doses.
Older adults in nursing homes, and those with multiple morbidities and NVAF, face a heightened risk of major bleeds and thrombotic events. The study supports the use of reduced-dose DOACs for this population due to the potential dangers and unclear benefits associated with standard dosing. The research emphasizes the importance of considering reduced doses for older adults with multiple chronic medical conditions, given their vulnerability to adverse drug effects.
“Our Great Plains QIN team reviewed nursing home adverse drug event data (CMS claims data). The data indicated that most transfers from the nursing home to the emergency department, related to an adverse drug event, are for bleeding disorders from anticoagulant use. A potential reduction strategy might be to share a copy of the Journal of the American Heart Association study with your clinical team and medical director to help drive practice change,” shared Tammy Wagner, RN, LSSGB; Great Plains QIN Quality Improvement Advisor.
Additional Resources:
- Anticoagulation Forum
- CDC – Anticoag Manager App
- Anticoagulation Toolkit – Developed by the Michigan Anticoagulation Quality Improvement Initiative
Learn more from our Adverse Drug Event Focus 4 Health Series
- Strategies to Prevent Adverse Drug Events: Recording
- Tactics to Reduce ADE’s with Prescribing & Transcribing of Medications: Recording
- Dispensing and Administration: Recording
- How Care Coordination Can Help in Preventing ADE’s: Recording
Listen to Our Podcast – Q-Tips For Your Ears
What Are Adverse Drug Events?: Adverse drug events happen every day and can occur with anyone who is taking a medicine. What is an adverse drug event, how does it happen and what can I do to help reduce the risk? Take a few minutes to listen and learn more.
How to Stay Out of The Emergency Department: When should the Emergency Department (ED) be utilized and when should a person monitor their symptoms at home? When should someone visit the doctor’s office or an urgent care clinic? Why is ED overuse important and why does it matter? Take a few minutes to listen and learn more.