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Colet C, Amador TA, Castro S, Figueras A, Heineck I. Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil). BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
| | | | - Stela Castro
- Universidade Federal do Rio Grande do Sul, Brazil
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Colet C, Amador TA, Heineck I. Therapeutic itinerary: trajectory for resolution of adverse events of patients using warfarin in Southern Brazil. BRAZ J PHARM SCI 2018. [DOI: 10.1590/s2175-97902018000317738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Christiane Colet
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Brazil
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[Which place for direct oral anticoagulants in routine hospital medical practice?]. Rev Med Interne 2015; 36:813-7. [PMID: 26320364 DOI: 10.1016/j.revmed.2015.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 05/06/2015] [Accepted: 06/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE More than one million patients received an oral anticoagulant treatment in France. This medication is the first aetiology of iatrogenic events. Recently, direct oral anticoagulant (DOA) provided efficacy and safety in the treatment of atrial fibrillation and venous thromboembolic events. Given the growing increase in the prescription of these molecules, with many advantages but also disadvantages, it seemed interesting to assess in routine hospital medical practice, the proportion of patients for which the initiation of AOD could be safe. METHODS This prospective, observational study was conducted in the department of internal medicine from October 2012 and September 2013. All inpatients receiving oral anticoagulant treatment have been included. Demographic data, indication of anticoagulant treatment, contraindications and interactions have been reported. From these information, we have established the percentage of patients who could benefit from DOA safely and securely. RESULTS Two hundred and ninety inpatients were included with a mean age of 76.3±15.2 years old. Atrial fibrillation and thromboembolic venous disease were the most prevalent indications of anticoagulant treatments (67.2% and 22.4% of cases respectively). Among all patients, 260 had an indication of DOA (89.7%), authorized by the French National health agency. Eighty percent had both indication and no contraindication for DOA. However, only 53.1% of patients neither had drug-drug interaction. Main contraindications were severe renal failure (clearance<30mL/min) in 10.7% of cases, and recent history of gastric ulcer in 15.3% of cases. The most frequent interactions with DOA were antiplatelet agent (14.5%) and amiodarone (11.6%). Almost two thirds of inpatients (65.1%) had at least one drug-drug interaction with VKA. CONCLUSION These results, coming from "real life", provide that only 53.1% of inpatients under anticoagulants could receive DOA safely. Caution is warranted, and VKA still have a preponderant role among anticoagulant drugs.
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Samadoulougou AK, Naibe DT, Mandi DG, Kabore E, Millogo GRC, Yameogo NV, Kologo JK, Tall AT, Toguyeni BJY, Zabsonre P. [Evaluation of the knowledge of patients about the management of treatment with anti-vitamin K drugs in the Service of Cardiology of Ouagadougou]. Ann Cardiol Angeiol (Paris) 2015; 64:263-267. [PMID: 26275496 DOI: 10.1016/j.ancard.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 01/04/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Vitamin K antagonists (VKA), the most widely prescribed oral anticoagulant therapy, represent a major public health problem by the adverse events related to their use. The aim of this study was to clarify the level of knowledge that patients have about the management of their oral anticoagulant treatment. PATIENTS AND METHODS This was a descriptive cross-sectional study performed at Yalgado Ouedraogo university Hospital, over a period of three months starting from March 1st to May 31st 2012. A questionnaire was given to patients receiving VKA treatment for at least a month. RESULTS Seventy patients were enrolled in the study of which 30 men. The median age was 49±16 years. Heart disease and venous thromboembolic disease justifying the introduction of VKA treatment were found respectively in 58.6 and 41.4% of the cases. The name of the VKA and the exact reason for the treatment were known respectively in 91.4 and 61.7% of the case. More than half of patients (68.6%) knew that the VKA makes blood more fluid. Forty-six patients (65.7%) cited INR as biological monitoring of treatment but only 28 patients (40%) were aware of INR target values. The majority of patients did not know the risks in case of overdose (72.8%) and underdosing (71.4%). Self-medication by non-steroidal anti-inflammatory drugs was reported by 18 patients (25.7%). Cabbage (74.3%) and lettuce (62.9%) were the main foods reported to be consumed moderately. CONCLUSION The knowledge of patients on the management of VKA is fragmentary and remains insufficient to ensure the effectiveness of the treatment. The creation of a therapeutic education program is then necessary.
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Affiliation(s)
- A K Samadoulougou
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso; Unité de formation et de recherche en science de la santé, université de Ouagadougou, Ouagadougou, Burkina Faso
| | - D T Naibe
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso.
| | - D G Mandi
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso
| | - E Kabore
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso
| | - G R C Millogo
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso; Unité de formation et de recherche en science de la santé, université de Ouagadougou, Ouagadougou, Burkina Faso
| | - N V Yameogo
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso; Unité de formation et de recherche en science de la santé, université de Ouagadougou, Ouagadougou, Burkina Faso
| | - J K Kologo
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso
| | - A T Tall
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso
| | - B J Y Toguyeni
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso
| | - P Zabsonre
- Service de cardiologie, CHU Yalgado Ouédraogo, avenue du Capitaine-Thomas-Sankara, 03 BP, 702250 Ouagadougou, Burkina Faso; Unité de formation et de recherche en science de la santé, université de Ouagadougou, Ouagadougou, Burkina Faso
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Samadoulougou A, Temoua Naibe D, Mandi G, Yameogo RA, Kabore E, Millogo G, Yameogo NV, Kologo JK, Thiam Tall A, Toguyeni BJY, Zabsonre P. [Evaluation of the level of knowledge of patients on treatment with vitamin K antagonists in Ouagadougou cardiology department]. Pan Afr Med J 2014; 19:286. [PMID: 25870741 PMCID: PMC4391894 DOI: 10.11604/pamj.2014.19.286.5411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/31/2014] [Indexed: 11/28/2022] Open
Abstract
Introduction Les antivitamines K (AVK), traitement anticoagulant oral le plus largement prescrit, posent un réel problème de santé publique du fait de leur risque iatrogène. L'objectif de cette étude était de préciser le niveau de connaissance des patients sur la gestion de leur traitement par les AVK. Méthodes Il s'est agi d'une enquête transversale descriptive réalisée au CHU-Yalgado Ouédraogo, sur une période de 03 mois : du 1er mars au 31 mai 2012. Un questionnaire a été administré aux patients bénéficiant d'un traitement AVK depuis au moins un mois. Résultats Soixante-dix patients ont été inclus dans l'étude dont 30 hommes. L'âge moyen était de 49 ans ± 16 ans. Les cardiopathies et la maladie thromboembolique veineuse justifiant l'institution du traitement AVK étaient retrouvées respectivement dans 58,6% et 41,4% des cas. Le nom de l'AVK et la raison exacte du traitement étaient connus respectivement dans 91,4% et 67,1% des cas. Plus de la moitié des patients (68,6%) savaient que les AVK rendaient le sang plus fluide. Quarante-six patients (65,7%) citaient l'INR comme examen biologique de surveillance du traitement et seulement 28 patients (40%) connaissaient les valeurs cibles. La majorité des patients ne connaissait pas les risques encourus en cas de surdosage (72,8%) et de sous-dosage (71,4%). Une automédication par anti-inflammatoire non stéroïdien était signalée par 18 patients (25,7%). Les choux (74,3%) et la laitue (62,9%), aliments à consommer avec modération, étaient les plus cités. Conclusion Les connaissances des patients sur la gestion des AVK étaient fragmentaires et insuffisantes pour assurer la sécurité et l'efficacité du traitement. La création d'un programme d'éducation thérapeutique sur les AVK s'avère alors nécessaire.
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Affiliation(s)
- André Samadoulougou
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso ; Unité de Formation et de Recherche en Science de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Germain Mandi
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | | | - Elisé Kabore
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | - Georges Millogo
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso ; Unité de Formation et de Recherche en Science de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | - Nobila Valentin Yameogo
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso ; Unité de Formation et de Recherche en Science de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Anna Thiam Tall
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso
| | | | - Patrice Zabsonre
- Service de Cardiologie du CHU Yalgado Ouedraogo, Ouagadougou, Burkina Faso ; Unité de Formation et de Recherche en Science de la Santé, Université de Ouagadougou, Ouagadougou, Burkina Faso
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Les cliniques d’anticoagulants sont-elles efficaces en France ? Évaluation des performances de six cliniques dans la gestion des traitements par antivitamines K. Rev Med Interne 2013; 34:515-21. [DOI: 10.1016/j.revmed.2013.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 02/03/2013] [Indexed: 11/18/2022]
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Duroy E, de la Gastine B. [Serious hemorrhages related to vitamin K antagonist treated by prothrombic complexes: retrospective study conducted in 2008]. Rev Med Interne 2011; 32:529-36. [PMID: 21429637 DOI: 10.1016/j.revmed.2011.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 02/07/2011] [Accepted: 02/12/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE Vitamin K antagonist are widely used and clearly useful in the prevention of thrombotic and embolic events. However, they expose to hemorrhagic risk. The aim of this retrospective study was to describe the serious hemorrhagic events that occurred in patients treated with vitamin K antagonist and that required administration of prothrombotic complexes concentrates. METHODS A comparative analysis of the file of the central pharmacy (that dispensed the prothrombotic complexes concentrates) and patient data of the department of medical information was perform to ascertain the population of patients having received some prothrombotic complexes concentrates. Then, hospitalization reports were consulted to select the patients having presented a severe bleeding while receveiving vitamin K antagonist. We collected patients' characteristics, bleeding location, INR values, emergency care, seriousness and medical issue. Imputability was determined with the French method of pharmacovigilance. RESULTS In 2008, in Caen University hospital, 80 patients received prothrombotic complexes concentrates in the context of a serious hemorrhage due to vitamin K antagonist. Their mean age was 75years and the most common presentation was a neurological hemorrhage (38,7%). For 63,8% of the patients, there was an overdose in vitamin K antagonist. Twenty-two patients died during their hospitalization and 10 others presented later sequelas. None of the patients included in this study had been spontaneously declared to the pharmacovigilance. High imputability scores were positively correlated with INR (P=0.0002). CONCLUSION Quality of emergency care of hemorrhagic events due to vitamin K antagonist could be improved with a better application of the professional recommendations and a spontaneous declaration to pharmacovigilance.
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Affiliation(s)
- E Duroy
- Département d'Information Médicale, CHU Côte-de-Nacre, Avenue de la Côte-de-Nacre, BP 95182, 14033 Caen cedex 9, France.
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Al Hajje A, Calop N, Bosson JL, Calop J, Allenet B. Quels facteurs associés à la survenue d’un événement iatrogène hémorragique chez les patients sous antivitamines K ? ANNALES PHARMACEUTIQUES FRANÇAISES 2010; 68:36-43. [DOI: 10.1016/j.pharma.2009.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 11/10/2009] [Accepted: 11/12/2009] [Indexed: 10/20/2022]
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