A Real-World Evaluation of the Appropriateness of Rivaroxaban Prescription for Stroke Prevention in Patients with Atrial Fibrillation
10.3870/j.issn.1004-0781.2025.11.015
- VernacularTitle:真实世界心房颤动预防卒中患者利伐沙班的处方适宜性评价
- Author:
Tingting YAN
1
;
Zheng DING
1
Author Information
1. 中国医学科学院阜外医院药剂科,北京 100037
- Publication Type:Journal Article
- Keywords:
Rivaroxaban;
Atrial fibrillation;
Appropriateness of prescription
- From:
Herald of Medicine
2025;44(11):1808-1813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the appropriateness of rivaroxaban prescription in hospitalized patients with atrial fibrillation,in order to provide a reference for prescription quality improvement projects.Methods Electronic medical records of patients with atrial fibrillation using rivaroxaban from a tertiary hospital were retrospectively analyzed.The suitability of rivaroxaban prescription was evaluated according to its indications,contraindications,usage,and dosage.If the reduction does not meet the reduction standard,it is defined as"off-label low dose";If the reduction standard is met but not reduced,it is defined as"off-label high dose".Results In this study,4 211 patients with atrial fibrillation using rivaroxaban were included to evaluate the suitability of prescription,of which 61 patients(1.45%)had unsuitable indications and 358 patients(8.50%)had unsuitable combined use.The remaining 3 792 patients(mean age 61.6 years;male 68.75%)were evaluated for the dose suitability of rivaroxaban.Among them,18.57%prescriptions were evaluated as inappropriate dosage;16.27%were"off-label low dose"and 2.29%were"off-label high dose".The influencing factors of prescription dose suitability were analyzed,which showed that patients who were female,underweight,older,and with renal insufficiency were more likely to be prescribed an inappropriate dose(high or low,P<0.01).Conclusions The vast majority of the prescribed doses of rivaroxaban in the cohort of patients with atrial fibrillation in this study were appropriate.Given clinicians'concerns about the risk of bleeding,low-dose prescriptions were more common in females,underweight,older,and patients with renal insufficiency patients or those taking other bleeding-prone medications.The review and reminder of fine prescription can be completed by improving the setting conditions of the rational drug use software.
