Soukeina A Bassam
research student in Lebanese University
Title: Title: Evaluation of Factors Involved in the Imbalance of New Oral Anticoagulant and Vitamin K Antagonist
Biography
Biography: Soukeina A Bassam
Abstract
Anticoagulation therapy is a cornerstone in managing patients with thromboembolic diseases. The aim is to evaluate the factors of imbalance of new oral anticoagulant (NOAC) and acenocoumarol and to identify drug-related problem (DRP) related to their use. A prospective cross-sectional study was conducted during five months in a tertiary care hospital. Factors affecting INR and PTT value were assessed. DRP were identified and categorized according to Pharmaceutical Care Network Europe classification system. Out of 258 patients, only 43.18% were able to achieve their target INR compared to 84.15% who had controlled PTT. Having renal disease, anemia or on dialysis are among the factors that affect the range of INR (p <0.05); whereas smoking, renal disease, anemia and taking anti-platelets therapy were significantly affecting PTT (p <0.05). The overall prevalence of DRPs was 87.2% with the highest prevalence in patients taking acenocoumarol (96%) compared to 76.7% on dabigatran and 59% on rivaroxaban. Drug interaction was the most frequent DRP (83.3%), followed by inappropriate monitoring (42.6%) and dose too high (26.7%). Patients on NOAC have more control on PTT and less DRPs with a wide therapeutic index that enables them to be taken in fixed doses without the need for laboratory monitoring.