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Basic Clin Pharmacol Toxicol. 2017 Jul;121(1):37-43. doi: 10.1111/bcpt.12762. Epub 2017 Mar 8.

Switching, Adverse Effects and Use of Over-the-Counter Analgesics among Users of Oral Anticoagulants: A Pharmacy-based Survey.

Author information

1
Department of Public Health, Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense, Denmark.
2
OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
3
Copenhagen Sønderbro Pharmacy, Copenhagen, Denmark.
4
Marselisborg Pharmacy, Højbjerg, Denmark.
5
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
6
Faculty of Health, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Abstract

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 NSAIDs obtained over the counter was rare.

PMID:
28132418
DOI:
10.1111/bcpt.12762
[Indexed for MEDLINE]
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