Improved Dosing and Administration of Rivaroxaban when Prescribed by a Cardiologist.

Area of Science:

• Pharmacology
• Cardiology
• Health Services Research

Background:

• Rivaroxaban, a direct oral anticoagulant (DOAC), is crucial for reducing stroke risk in non-valvular atrial fibrillation (AF).
• A gap exists between recommended DOAC dosages and actual clinical practice, posing risks for patients.

Purpose of the Study:

• To evaluate real-world rivaroxaban prescribing patterns and patient adherence to dietary guidelines in AF patients.
• To determine the association between prescriber specialty and correct rivaroxaban dosing and administration.

Main Methods:

• Retrospective analysis of 116 AF patients prescribed rivaroxaban.
• Chi-Square test used to assess associations between prescriber specialty and correct dosing/administration.
• Evaluation of patient adherence to dietary requirements during rivaroxaban use.

Main Results:

• Cardiologists prescribed rivaroxaban most frequently (50.9%).
• 59.5% of patients correctly dosed and administered rivaroxaban with an adequate meal.
• Incorrect use (40.5%) was primarily due to inadequate meals (33.6%) or incorrect dosage (6.9%).
• Cardiologist prescriptions were associated with higher correct use (72.9%) compared to others (45.6%; p=0.003).
• Primary care providers' prescriptions showed lower correct use (44.4%; p=0.009), driven by meal non-adherence.

Conclusions:

• Inappropriate prescribing and patient non-adherence to DOACs, including rivaroxaban, have serious consequences.
• Systematic patient education on DOACs is vital across healthcare.
• Further research is needed on the clinical impact of non-adherence to rivaroxaban's dietary requirements.