Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017, University of Birmingham
Study discovers anticoagulant drugs are being prescribed against safety advice
Credit: University of Birmingham

A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

The study, published in the British Journal of General Practice, was carried out by researchers at the University of Birmingham's Institute of Applied Health Research.

Best practice guidelines recommend drugs such as warfarin are prescribed to patients with (AF), a heart condition that causes an .

First author Dr Nicola Adderley said: "These patients are at high risk of stroke and anticoagulant drugs greatly reduce the stroke risk as they make blood less likely to clot.

"However, because they reduce blood clotting, patients taking are at risk of bleeding complications.

"Therefore, safety advice is to avoid anticoagulants in patients who have certain conditions such as a bleeding peptic ulcer, or a previous stroke caused by a bleed."

The researchers reviewed patient records from 645 general practices over a 12-year period between 2004 and 2015. They found that AF patients with conditions making them a safety risk and those without safety risks were almost equally likely to be prescribed anticoagulants. The situation did not change over time.

Corresponding author Professor Tom Marshall said: "Our study shows that safety advice seems not to influence the prescribing of anticoagulants.

"We found that patients considered a safety risk were just as likely to be prescribed the drugs as those without safety risks, and this occurred in every year between 2004 and 2015.

"Because anticoagulants prevent strokes in people with this type of irregular pulse, GPs are encouraged to prescribe more anticoagulants to those who need them.

"This has been happening and it is good news. But the sting in the tail is that more people who perhaps shouldn't be on anticoagulants are also taking them: about 38,000 nationally.

"We need to understand the reasons for this and whether might come to any harm."

Explore further: Treatment gap in patients suffering from irregular heartbeat resulting in heightened risk of stroke

More information: Nicola Adderley et al. The role of contraindications in prescribing anticoagulants to patients with atrial fibrillation: a cross-sectional analysis of primary care data in the UK, British Journal of General Practice (2017). DOI: 10.3399/bjgp17X691685

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