{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:35:48Z","timestamp":1778056548277,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009882","name":"Regione Lombardia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009882","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Evidence on head\u2010to\u2010head comparison between direct oral anticoagulants (DOACs) is lacking, and the reasons for choosing one type of DOAC and switching from one DOAC to another are scarce. This study investigated the use of DOACs in an unselected population in Northern Italy during a recent period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the health administrative database of the Lombardy region, subjects aged 45\u2009years and older who started DOAC therapy between 2019 and 2022 were included in the analysis. Logistic regression analysis was used to evaluate predictors associated with DOAC prescription, and results were presented as ORs with 95% CI. DOAC switching was assessed by estimating the prevalence and cumulative incidence according to the first prescribed DOAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 159\u2009993 new users for DOAC were identified. Apixaban users increased from 29.0% to 34.3%, whereas dabigatran users decreased from 20.7% to 11.5% over time. Across all pair\u2010wise comparisons, older age and female sex were predictors for edoxaban prescription. Comorbidities were mainly associated with the use of apixaban; however, dabigatran was preferred in patients with a history of ischemic heart disease or myocardial infarction and rivaroxaban in those with peripheral artery disease. Both apixaban and edoxaban were preferentially prescribed to patients with a history of bleeding. The switching rate of DOACs was 5.6% with apixaban as the most preferred drug as a second choice. Dabigatran was mainly chosen as a second DOAC after a vascular ischaemic event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the lack of evidence on factors influencing clinician behavior in the use of DOACs, our findings provide insight into this topic in a real\u2010world setting. As the use of these agents increases, further evidence is needed to better explore this issue. Our data could contribute to the development of recommendations in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70300","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T04:45:04Z","timestamp":1765860304000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of Direct Oral Anticoagulant Use in Northern Italy: A Population\u2010Based Study"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2920-1669","authenticated-orcid":false,"given":"Luisa","family":"Ojeda\u2010Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Health Policy Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta","family":"Agostini","sequence":"additional","affiliation":[{"name":"Department of Health Policy Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Zanovello","sequence":"additional","affiliation":[{"name":"Department of Health Policy Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Prada","sequence":"additional","affiliation":[{"name":"Department of Health Policy Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida","family":"Fortino","sequence":"additional","affiliation":[{"name":"Directorate General for Health, Lombardy Region  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Augurio","sequence":"additional","affiliation":[{"name":"Lazzate ASST Brianza, Lombardy Region  Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0264-151X","authenticated-orcid":false,"given":"Marta","family":"Baviera","sequence":"additional","affiliation":[{"name":"Department of Health Policy Istituto di Ricerche Farmacologiche Mario Negri IRCCS  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-0511"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/suaa100"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.06.114"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-020-02367-2"},{"key":"e_1_2_11_7_1","unstructured":"Agenzia Italiana del Farmaco \u201cPrescription of OAC Therapy Covered by the National Health Service for Non\u2010Valvular Atrial Fibrillation \u201dPublished on: 06 april 2023 https:\/\/www.aifa.gov.it\/\u2010\/report\u2010sulle\u2010prescrizioni\u2010dei\u2010farmaci\u2010con\u2010nota\u201097\u2010effettuate\u2010tramite\u2010il\u2010sistema\u2010ts\u2010nel\u20102022."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05904-0"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2158"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.15582"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab303"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062379"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j5058"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.086"},{"issue":"22","key":"e_1_2_11_15_1","article-title":"Erratum to: Practice\u2010Derived Data on Non\u2010Vitamin K Antagonist Oral Anticoagulant (NOAC) Therapy to Complement Observations From Randomized Trials","volume":"17","author":"ESC","year":"2020","journal-title":"European Heart Journal. Supplements"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.008"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-015-0452-4"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2019.100465"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000001118"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1999.1823"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.10.012"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04858"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.70300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T07:27:49Z","timestamp":1767079669000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.70300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":21,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/pds.70300"],"URL":"https:\/\/doi.org\/10.1002\/pds.70300","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70300"}}