Abstract
OBJECTIVE: To determine the extent to which there is a guideline-based indication for concomitant use of acetylsalicylic acid (ASA) and acenocoumarol in a large, non-academic, Dutch hospital. DESIGN Case series. METHODS: Drug interaction safety signals generated in Rijnstate Hospital for ASA and acenocoumarol from April through June 2013 were used to identify patients with combined therapy. Patient files were analysed to determine indications and the duration of combined therapy. Three groups of patients were distinguished: guideline-based indication for concomitant use (I); no guideline-based indication and combination shorter (II) or longer (III] than one month. RESULTS: Of the 80 patients who used ASA and acenocoumarol concomitantly only 31 (39%) had a proper indication for combined use. Of the 49 patients who had no such indication, 15 (31%) used the combination longer than a month. No proton pump inhibitor was prescribed for 15 of 54 patients with risk factors for bleeding. It appeared that ASA was frequently continued after the start of acenocoumarol, and stopped when a therapeutic INR was measured twice. CONCLUSION: This study shows that combined therapy with ASA and acenocoumarol occurs frequently in Rijnstate Hospital. In more than half of the cases we could not find a proper indication for combined use according to the current guidelines.
| Translated title of the contribution | Combined therapy with acetylsalicytic add and coumarins: A study of the adherence to guidelines |
|---|---|
| Original language | Dutch |
| Pages (from-to) | 79-82 |
| Number of pages | 4 |
| Journal | Pharmaceutisch Weekblad |
| Volume | 150 |
| Issue number | 16 |
| Publication status | Published - 17 Apr 2015 |
| Externally published | Yes |