Antithrombotic rx could be optimized for older A-fib patients

(HealthDay)—A considerable proportion of older patients with atrial fibrillation (AF) are not prescribed antithrombotics, according to a study published online April 7 in the Journal of Clinical Pharmacy and Therapeutics.

Prasad S. Nishtala, Ph.D., from the University of Otago in New Zealand, and colleagues conducted a retrospective study involving a random sample of de-identified residential medication management reviews conducted by accredited pharmacists in aged care homes. Participants were 146 residents aged 65 years or older with AF living in residential aged care facilities. Antithrombotic therapy was assessed before and after medication review.

The researchers found that all residents were at high risk of developing stroke. Overall, 78.8 percent of residents with AF were prescribed antithrombotics. Usage of anticoagulants was relatively low (28.1 percent), and there were few recommendations to change thromboprophylactic therapy in AF from the medication review pharmacists. Based on application of the CHA₂DS₂-VASc risk tool, all residents were eligible for antithrombotic treatments; of these, 50.7 and 28.1 percent, respectively, were prescribed antiplatelets and anticoagulants. Overall, 67.7 percent of the 31 residents with AF not prescribed antithrombotics had relative contraindications for anticoagulant treatments.

"The use of guideline-recommended stroke risk tools could assist medication review pharmacists in optimizing antithrombotic therapy in older adults with AF," the authors write.

Two authors disclosed financial ties to Meditrax.