title: [Appropriateness of the prescriptions of conventional versus new oral anticoagulants at discharge from a department of internal medicine].
abstract: BACKGROUND
  The recently introduced oral direct anticoagulants (ODAs), presumably safer, and with comparable efficacy to the vitamin K antagonists (VKAs), may reshape the world of anticoagulation medicine. This study aimed to assess the prescription appropriateness of ODAs and VKAs at discharge from hospital.
  
  
  METHODS
  We performed a one year retrospective study between August 2012 and July 2013 in the department of internal medicine of a regional hospital (HVs Sion) using Electronic Medical Records. All patients receiving an ODA were included and matched to a patient treated with a VKA. The appropriateness of prescription at discharge was defined by an adequate indication and dosing, the absence of contraindication, a minimal risk of drug-drug interactions and no major bleeding or venous thromboembolism during the hospitalization. The bleeding risk was evaluated with the HAS-BLED score when the indication was atrial fibrillation (AF).
  
  
  RESULTS
  Out of the 44patients included (22 with an ODA and 22 with a VKA), 38 received an appropriate prescription according to all criteria. Two patients had an inadequate dosing. A potential drug-drug interaction was detected in 3patients receiving a VKA and in 1patient receiving an ODA. No major contraindication was found, but a relative contraindication was discussed in 3cases. The majority of patients receiving an ODA for an AF had a minor bleeding risk.
  
  
  CONCLUSIONS
  No significant difference was ascertained between the two groups regarding the appropriateness of prescription. Our results suggest that ODAs were cautiously used in our setting.
authors.affiliation: Service de pharmacie, institut central (ICHV), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse.
authors.forename: L
authors.initials: L
authors.lastname: Bochatay
authors.affiliation: Service de pharmacie, institut central (ICHV), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse.
authors.forename: J
authors.initials: J
authors.lastname: Beney
authors.affiliation: Service de pharmacie, institut central (ICHV), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse.
authors.forename: V
authors.initials: V
authors.lastname: Jordan-von Gunten
authors.affiliation: Service de médecine interne, hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse.
authors.forename: P A
authors.initials: PA
authors.lastname: Petignat
authors.affiliation: Service de pharmacie, institut central (ICHV), hôpital du Valais, avenue du Grand-Champsec 86, 1951 Sion, Suisse. Electronic address: lucien.roulet@hopitalvs.ch.
authors.forename: L
authors.initials: L
authors.lastname: Roulet
mesh_terms: D000074:Acenocoumarol / Q000009:adverse effects / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000628:therapy; D017115:Catheter Ablation; D000069604:Dabigatran / Q000009:adverse effects / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010644:Phenprocoumon / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D000069552:Rivaroxaban / Q000009:adverse effects / Q000627:therapeutic use; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D000069552:Rivaroxaban; D000069604:Dabigatran; D000074:Acenocoumarol; D010644:Phenprocoumon
keywords: Acenocoumarol; Acénocoumarol; Anticoagulants oraux; Dabigatran; Oral anticoagulants; Rivaroxaban