1.A national audit on the utilisation and documentation of dabigatran checklist for patients initiated on dabigatran
Doris George ; Navin Kumar Devaraj ; Shakirin Shaik Rahmat ; Sahimi Mohamed ; Noraini Mohamad
The Medical Journal of Malaysia 2019;74(5):425-430
Background: Direct oral anticoagulants (DOACs) especially
dabigatran, have gain popularity for their efficacy, fixed
dosing and favourable safety profile. A dabigatran
prescribing checklist has been prepared by the Ministry of
Health, Malaysia (MOH) to ensure rational and safe
prescribing of dabigatran. This study therefore aimed to
audit the utilization and documentation of this checklist and
use of dabigatran in the government healthcare facilities.
Methods: This is a nationwide retrospective audit on the
documentation of Dabigatran Prescribing and Dispensing
Checklist for a period of two years from January 2013 till
December 2014. Data from these Dabigatran Checklists
(indication, dose, duration, renal function and adverse drug
reactions encountered) were extracted by the pharmacist at
MOH healthcare facilities.
Results: A total of 52 out of 56 (92.9%) of MOH facilities
complied to usage of checklist at their centres involving a
total of 582 patients of which 569 (97.7%) patients were
initiated on dabigatran for the approved indications. The
recommended dose of dabigatran was used correctly in 501
(99.6%) of patients. Reason for switching to DOACs use was
only documented in 76.7% (131/171) of patients. The most
common reason for switching from warfarin was poor INR
control (n=39), history of bleeding/overwarfarinisation
(n=22) and unable to attend regular INR clinic (n=21).
There were 75 cases of adverse events reported. The most
common adverse event reported were abdominal discomfort
(n=10) followed by gum bleeding (n=9) and dizziness (n=5).
Conclusions: Compliance to the dabigatran check list was
high with 70% of patients prescribed the appropriate dosing.