The use of new oral anticoagulants in geriatric patients: A survey study for physicians

Tuberk Toraks. 2021 Mar;69(1):65-73. doi: 10.5578/tt.20219908.

Abstract

Introduction: The use of new oral anticoagulants (NOACs) for the treatment of thromboembolic diseases is becoming more widespread. The present study brings together the opinions and daily routine clinical practices of physicians regarding the use of NOACs in the geriatric age group for the treatment of venous thromboembolic diseases.

Materials and methods: The study accessed 274 physicians (197 attending, 70 resident and seven primary care physicians) with various specialties and academic positions through face-to-face interviews or e-mails, and asked them to complete a questionnaire form prepared for NOAC use on a voluntary basis between 1 May and 31 December 2019.

Result: It was found that physicians preferred NOACs mostly for patients contraindicated for the regular use of low-molecular-weight heparins and warfarin (n: 264, 96%), and with an unbalanced INR level (n: 230, 87%). The use of NOACs was found to be higher in the geriatric age group than other anticoagulants due to the easy dose adjustment, the extended monitoring intervals and the low risk of bleeding. Among the physicians, neither the specialty nor a higher number of occupational working years affected the preference for NOACs or other anticoagulants.

Conclusions: Our study has demonstrated that physicians consider NOACs to be a good treatment option in terms of efficacy and reliability for the treatment of thromboembolic diseases in the geriatric age group, who may have treatment compliance difficulties. It was found also that they plan treatment considering the benefit-to-harm ratio and the bleeding-ischemic event balance.

MeSH terms

  • Administration, Oral
  • Aged
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / chemically induced
  • Atrial Fibrillation / drug therapy
  • Female
  • Hemorrhage / chemically induced
  • Hemorrhage / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Physicians
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Reproducibility of Results
  • Stroke / chemically induced
  • Stroke / drug therapy
  • Surveys and Questionnaires
  • Venous Thromboembolism / drug therapy*
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin