[Are general practitioners in Paris and surrounding areas reticent about direct oral anticoagulants?]

Determine how familiar general practitioners (GPs) working in Paris and surrounding areas are with prescriptions for direct oral anticoagulants (DOACs).

A questionnaire sent to 189 GP working in Paris and surrounding areas yielded 100 responses. Data collected included a brief summary of sociodemographic items, comparative knowledge about DOACs and vitamin K antagonists (VKAs), and responses to two clinical situations for DOAC prescriptions (renewal of a first prescription).

The majority (65%) of the responding GPs were over 50. The GPs were knowledgeable about data in the literature concerning the following items: patient quality of life (72% considered it improved); adherence (55% suggested it was improved); rules for DOAC prescription (88% knew the set doses; 81% knew biological monitoring does not exist; 38% were aware of potential interactions). They were not knowledgeable about the following points: main sites for bleeding risks are the gut and the brain; 44% thought risk was lowered for gastrointestinal bleeding and concerning brain hemorrhages 26% thought there was a lesser risk while 40% had no opinion; cost (20% thought it was lower). For prescription modalities, 90% of the GPs renewed the DOAC previously prescribed for non-valvular atrial fibrillation while 76% preferred a LMWH-VKA scheme for the first prescription for deep vein thrombosis.

Without being reticent about DOACs, the GPs questioned in this study recognized the usefulness of these medications for their patients' quality of life but were hesitant to use DOACs as the first intention anticoagulant, undeniably due to lack of experience and knowledge about the lower risk of bleeding. Initial training and continuing education should be strengthened on this point with dedicated workshops.