{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:28:03Z","timestamp":1790962083987,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Knowledge on the prescriptive practice of direct oral anticoagulants (DOACs) in older subjects with atrial fibrillation (AF) hospitalized in acute medical wards is limited. This study aimed to evaluate the prevalence and appropriateness of DOAC prescriptions in hospitalized older subjects with AF, discharged from acute medical wards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed a cohort of 609 subjects with AF, aged \u226565\u2009years (mean age 85\u2009years) enrolled from 39 geriatric and nephrology wards in Italy. DOAC prescriptive appropriateness was evaluated according to the summary of product characteristics (smPC), 2019 Beers and STOPP criteria, and drug\u2013drug interactions (DDIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At hospital discharge, 33% of patients with AF were prescribed with DOAC, 26% with vitamin\u2010K antagonist, while 41% did not receive any anticoagulant. Among subjects on DOAC therapy, 31% presented a violation of the smPC criteria (mainly underdosage\u201417%), while 48% and 18% presented a Beers\/STOPP inappropriate prescription, or a DDI, respectively. Older age, lower body mass index (BMI), cancer and higher estimated glomerular filtration rate (eGFR) were independently associated with DOAC underdosage or missed prescription (age: adjusted odds ratio [aOR] 1.06, 95% confidence interval [95% CI] 1.00\u20131.12 for underdosage; eGFR: aOR 1.04, 95% CI 1.02\u20131.07 for underdosage; BMI: aOR 0.95, 95% CI 0.91\u20130.99 for missed prescription; cancer: aOR 1.93, 95% CI 1.19\u20133.13 for missed prescription).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study showed a suboptimal DOAC prescriptive practice in older in\u2010patients, with frequent missed prescription and DOAC underdosage. Contrary to current recommendations, physicians appear overly concerned by bleeding risk in real\u2010life older and frailer subjects. Strategies should be developed to promote appropriate DOAC prescription in the hospital setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16010","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T08:34:15Z","timestamp":1707294855000},"page":"1231-1239","source":"Crossref","is-referenced-by-count":8,"title":["Appropriateness of direct oral anticoagulant prescribing in older subjects with atrial fibrillation discharged from acute medical wards"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0220-0500","authenticated-orcid":false,"given":"Antonio","family":"De Vincentis","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Internal Medicine, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Soraci","sequence":"additional","affiliation":[{"name":"Unit of Geriatric Medicine IRCCS INRCA  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Arena","sequence":"additional","affiliation":[{"name":"Research Unit of Internal Medicine, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Sciacqua","sequence":"additional","affiliation":[{"name":"Unit of Geriatric Medicine, Department of Medical and Surgical Sciences \u201cMagna Graecia\u201d University of Catanzaro  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Armentaro","sequence":"additional","affiliation":[{"name":"Unit of Geriatric Medicine, Department of Medical and Surgical Sciences \u201cMagna Graecia\u201d University of Catanzaro  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Aucella","sequence":"additional","affiliation":[{"name":"SC di Nefrologia e Dialisi IRCCS \u201cCasa Sollievo della Sofferenza\u201d  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Corsonello","sequence":"additional","affiliation":[{"name":"Unit of Geriatric Medicine IRCCS INRCA  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Aucella","sequence":"additional","affiliation":[{"name":"SC di Nefrologia e Dialisi IRCCS \u201cCasa Sollievo della Sofferenza\u201d  San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Antonelli Incalzi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"},{"name":"Research Unit of Internal Medicine, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2011.03.003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010022\u201003279\u2010x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266\u2010020\u201000767\u2010w"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2019.05.002"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13631"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14029"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.01220"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux316"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S129235"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845\u2010018\u20101837\u20107"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14071410"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014108"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.996042"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010157\u20107\u2010201210020\u201000003"},{"key":"e_1_2_10_16_1","unstructured":"European Medicines Agency.Summary of product characteristics: pradaxa. 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