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Switching, Adverse Effects and Use of Over‐the‐Counter Analgesics among Users of Oral Anticoagulants: A Pharmacy‐based Survey
Author(s) -
Hellfritzsch Maja,
Hyllested Lea Maria Rønneberg,
Meegaard Line,
WibergHansen Alexander,
Grove Erik Lerkevang,
Pottegård Anton
Publication year - 2017
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12762
Subject(s) - medicine , adverse effect , vitamin k antagonist , over the counter , anticoagulant , pharmacy , medical prescription , rivaroxaban , drug , aspirin , apixaban , atrial fibrillation , intensive care medicine , anesthesia , warfarin , pharmacology , family medicine
Oral anticoagulants are widely used but information on important aspects in that respect is not available from medical registers or clinical databases. Therefore, we conducted a survey including patients filling a prescription for oral anticoagulants at two large Danish community pharmacies. We collected information concerning the patients’ knowledge of their anticoagulant treatment including prior drug switching. Further, patients were asked about use of over‐the‐counter analgesics, adverse effects and how the treatment affected their everyday life. Among 335 eligible patients, 301 (90%) agreed to participate. Atrial fibrillation was the most common indication (65%), and most patients filled a prescription for a non‐vitamin K antagonist oral anticoagulant ( NOAC ) (58%). Among the 12% (n = 35) of participants who had switched oral anticoagulant treatment, 69% had switched from a vitamin K antagonist ( VKA ) to a NOAC . Switching was most frequently caused by inconvenience (34%) and adverse effects (23%). Although half of all patients had recently bought over‐the‐counter analgesics, purchase of ibuprofen and aspirin was rare (6%). More VKA users than NOAC users felt limited in their everyday life because of anticoagulant treatment (18% versus 9%). Among non‐incident NOAC users, 21% had experienced adverse effects during their current treatment. Based on first‐hand information from a large sample of anticoagulant users, we conclude that the main drug‐related issues leading to anticoagulant switching and perceived limitations in everyday life were inconvenience and adverse effects. This varied between drug groups. Further, use of NSAID s obtained over the counter was rare.