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https://www.readbyqxmd.com/read/28528365/the-value-of-evidence-in-the-decision-making-process-for-reimbursement-of-pharmacogenetic-dosing-of-warfarin
#1
Andrej Janzic, Igor Locatelli, Mitja Kos
BACKGROUND: After early clinical trials that evaluated pharmacogenetic (PG) algorithms, many healthcare payers were reluctant to cover this technology and, consequently, PG dosing of warfarin could not be translated into clinical practice. OBJECTIVE: The aim of this study was to estimate the value of upgrading evidence relating to PG dosing of warfarin from the healthcare payer perspective. METHODS: Randomized controlled trials (RCTs) that evaluated PG dosing of warfarin were identified through a systematic literature search, and their findings were combined by a cumulative meta-analysis...
May 20, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28515748/effects-of-propolis-on-warfarin-efficacy
#2
Esin Akbay, Çiğdem Özenirler, Ömür Gençay Çelemli, Ahmet Baris Durukan, Mehmet Ali Onur, Kadriye Sorkun
INTRODUCTION: Warfarin is commonly used to avoid thromboembolism, predominantly for cardiovascular pathologies. However, the consumption of several herbal products is not permitted during its use due to the associated interactions. Propolis is a popular phytotherapy product made by honey bees. The use of propolis has been dramatically increasing in recent times. AIM: To evaluate the possible interactions between propolis and warfarin in a mouse model with determination of the international normalized ratio (INR) values...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28508324/impact-of-clinical-pharmacist-intervention-in-anticoagulation-clinic-in-sudan
#3
Nahid Osman Ahmed, Bashier Osman, Yassein Mohamed Abdelhai, Tariq Muhammed Hashim El-Hadiyah
Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care...
May 15, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28503249/hierarchical-models-for-multiple-rare-outcomes-using-massive-observational-healthcare-databases
#4
Trevor R Shaddox, Patrick B Ryan, Martijn J Schuemie, David Madigan, Marc A Suchard
Clinical trials often lack power to identify rare adverse drug events (ADEs) and therefore cannot address the threat rare ADEs pose, motivating the need for new ADE detection techniques. Emerging national patient claims and electronic health record databases have inspired post-approval early detection methods like the Bayesian self-controlled case series (BSCCS) regression model. Existing BSCCS models do not account for multiple outcomes, where pathology may be shared across different ADEs. We integrate a pathology hierarchy into the BSCCS model by developing a novel informative hierarchical prior linking outcome-specific effects...
August 2016: Statistical Analysis and Data Mining
https://www.readbyqxmd.com/read/28454906/the-association-between-patient-reported-medication-adherence-and-anticoagulation-control
#5
Jonathan Sevilla Cazes, Brian S Finkleman, Jinbo Chen, Colleen M Brensinger, Andrew E Epstein, Michael B Streiff, Stephen E Kimmel
BACKGROUND: The prevention of thromboembolism events remains challenging in cases of poor medication adherence. Unfortunately, clinical prediction of future adherence has been suboptimal. OBJECTIVE: To examine the correlation between two measures of real-time, self-reported adherence and anticoagulation control. METHODS: The IN-RANGE2 Cohort recruited patients initiating warfarin therapy in 3 urban anticoagulation clinics. At each study visit, participants reported adherence using a 100-point Visual Analogue Scale (VAS, marking % of pills taken since prior visit on a linear scale) and 7-day recall of pill taking behavior...
April 25, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28424132/outcomes-of-recreational-activity-associated-trauma-in-elderly-persons-on-blood-thinning-medications
#6
Zachary M DeBoard, Jonathan Grotts, Lisa Ferrigno
With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28363354/management-of-major-bleeding-in-patients-with-atrial-fibrillation-treated-with-non-vitamin-k-antagonist-oral-anticoagulants-compared-with-warfarin-in-clinical-practice-from-phase-ii-of-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation
#7
Benjamin A Steinberg, DaJuanicia N Simon, Laine Thomas, Jack Ansell, Gregg C Fonarow, Bernard J Gersh, Peter R Kowey, Kenneth W Mahaffey, Eric D Peterson, Jonathan P Piccini
Non-vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed to assess the frequency, management, and outcomes of major bleeding in the setting of community use of NOACs. Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry, we analyzed rates of International Society on Thrombosis and Haemostasis major bleeding and subsequent outcomes in patients treated with NOACs versus warfarin...
May 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28355459/laboratory-monitoring-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-review
#8
John W Eikelboom, Daniel J Quinlan, Jack Hirsh, Stuart J Connolly, Jeffrey I Weitz
Importance: The non-vitamin K antagonist oral anticoagulants (NOACs) apixaban, dabigatran, edoxaban, and rivaroxaban are administered in fixed doses without anticoagulant monitoring. Randomized trials show that unmonitored NOAC therapy is at least as effective as and safer than dose-adjusted warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Subgroup analyses indicate that plasma drug levels or anticoagulant activity of the NOACs predict stroke and bleeding...
May 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28340451/the-role-of-drug-drug-interactions-in-prostate-cancer-treatment-focus-on-abiraterone-acetate-prednisone-and-enzalutamide
#9
REVIEW
Marzia Del Re, Stefano Fogli, Lisa Derosa, Francesco Massari, Paul De Souza, Stefania Crucitta, Sergio Bracarda, Daniele Santini, Romano Danesi
Elderly patients with cancer may have comorbidities, each requiring additional pharmacologic treatment. Therefore, the occurrence of pharmacokinetic (PK) and pharmacodynamic (PD) interactions is very likely, and the risk of adverse reactions (ADRs), due to the narrow therapeutic window of anticancer drugs, is increased. Drug-drug interactions (DDIs) may occur in prostate cancer patients due to inhibition by abiraterone of liver cytochrome P450 (CYP)-dependent enzymes CYP2C8 and 2D6, which are involved in the metabolism of approximately 25% of all drugs, and induction by enzalutamide of CYP3A4, 2C9 and 2C19, which metabolize up to 50% of medications...
March 9, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#10
REVIEW
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28329059/anticoagulation-for-pregnant-women-with-mechanical-heart-valves-a-systematic-review-and-meta-analysis
#11
Rohan D'Souza, Jackie Ostro, Prakesh S Shah, Candice K Silversides, Ann Malinowski, Kellie E Murphy, Mathew Sermer, Nadine Shehata
Aims: To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice. Methods and results: Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles...
May 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28319424/rivaroxaban-in-patients-with-atrial-fibrillation-from-rocket-af-to-everyday-practice
#12
Gonzalo Barón-Esquivias, Francisco Marín, Marcelo Sanmartín Fernandez
Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban...
May 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28314139/patients-experiences-of-atrial-fibrillation-and-non-vitamin-k-antagonist-oral-anticoagulants-noacs-and-their-educational-needs-a-qualitative-study
#13
Danielle E Clarkesmith, Gregory Y H Lip, Deirdre A Lane
PURPOSE: Qualitative research on atrial fibrillation (AF) patient's experiences and perceptions of taking the non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention is limited. This study explores patients' experiences of dabigatran and their recommendations for development of educational materials. PATIENTS AND METHODS: Semi-structured individual interviews with 8 warfarin-naive and 8 warfarin-experienced AF patients, using qualitative deductive thematic analysis...
March 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28300284/predictors-and-variability-of-drug-eluting-vs-bare-metal-stent-selection-in-contemporary-percutaneous-coronary-intervention-insights-from-the-prism-study
#14
Ali Shafiq, Kensey Gosch, Amit P Amin, Henry H Ting, John A Spertus, Adam C Salisbury
Drug-eluting stents (DES) reduce risk of in-stent restenosis after percutaneous coronary intervention (PCI) but require dual antiplatelet therapy (DAPT) for a longer term than bare-metal stents (BMS). Few studies have examined clinical predictors of DES vs BMS, and variability in provider selection between DES and BMS in clinical practice has not been well described. These insights can inform our understanding of current practice and may identify opportunities to improve decision-making stent selection decinsion-making...
March 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28290558/-real-world-data-on-novel-oral-anticoagulants-the-added-value-of-registries-and-observational-studies-focus-on-apixaban
#15
Francesco Pelliccia, Gaetano Tanzilli, Michele Schiariti, Nicola Viceconte, Cesare Greco, Carlo Gaudio
Anticoagulant therapy has been used with great effect for decades for the prevention of stroke among patients with atrial fibrillation. In recent years, the therapeutic armamentarium has been strengthened considerably, with the addition of anticoagulants acting through novel pathways. The currently available novel agents are apixaban, rivaroxaban and dabigatran. These novel oral anticoagulants (NOACs) were approved for use on the basis of major clinical trials clearly demonstrating improved risk reductions compared to warfarin for stroke and/or major bleeding events...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28286333/early-non-persistence-with-dabigatran-and-rivaroxaban-in-patients-with-atrial-fibrillation
#16
Cynthia A Jackevicius, Meytal Agvil Tsadok, Vidal Essebag, Clare Atzema, Mark J Eisenberg, Jack V Tu, Lingyun Lu, Elham Rahme, P Michael Ho, Mintu Turakhia, Karin H Humphries, Hassan Behlouli, Limei Zhou, Louise Pilote
OBJECTIVE: Dabigatran and rivaroxaban are novel oral anticoagulants (NOACs) approved for stroke prevention in atrial fibrillation (AF). Although NOACs are more convenient than warfarin, their lack of monitoring may predispose patients to non-persistence. Limited information is available on NOAC non-persistence rates and related clinical outcomes in clinical practice. METHODS: We conducted a retrospective cohort study using administrative data from Ontario, Canada, from January 1998 to March 2014 of patients with AF who were dispensed dabigatran or rivaroxaban...
March 12, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#17
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28276567/patient-values-and-preferences-for-antithrombotic-therapy-in-atrial-fibrillation-a-narrative-systematic-review
#18
Peter S Loewen, Angela Tianshu Ji, Anita Kapanen, Alison McClean
Guidelines recommend that patients' values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. RESEARCH QUESTIONS: 1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included...
March 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28237982/associations-between-ischemic-stroke-follow-up-socioeconomic-status-and-adherence-to-secondary-preventive-drugs-in-southern-sweden-observations-from-the-swedish-stroke-register-riksstroke
#19
Teresa Ullberg, Eva-Lotta Glader, Elisabet Zia, Jesper Petersson, Marie Eriksson, Bo Norrving
BACKGROUND: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. METHODS: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention...
February 25, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28231618/the-patients-perspective-of-international-normalized-ratio-self-testing-remote-communication-of-test-results-and-confidence-to-move-to-self-management
#20
Anne Grogan, Michael Coughlan, Geraldine Prizeman, Niamh O'Connell, Nora O'Mahony, Katherine Quinn, Gabrielle McKee
AIMS AND OBJECTIVES: To elicit the perceptions of patients, who self-tested their international normalized ratio and communicated their results via a text or phone messaging system, to determine their satisfaction with the education and support that they received and to establish their confidence to move to self-management. BACKGROUND: Self-testing of international normalized ratio has been shown to be reliable and is fast becoming common practice. As innovations are introduced to point of care testing, more research is needed to elicit patients' perceptions of the self-testing process...
February 23, 2017: Journal of Clinical Nursing
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