Debbie Rigby takes a look at the latest in research news
A UK population-based cohort study and linked registries from Denmark has shown that patients with AF who discontinue oral anticoagulant therapy have a significant twofold to threefold higher risk of ischaemic stroke compared with those who continue therapy. Oral anticoagulants including warfarin and direct-acting oral anticoagulants reduce the risk of stroke in patients with atrial fibrillation by around two-thirds. Clinical guidelines thus recommended life-long oral anticoagulant therapy for patients with AF at increased stroke risk.
A systematic review and meta-analysis of published randomized controlled trials of DOAC versus warfarin concludes that DOAC agents are preferable over warfarin as stroke prevention therapy for patients with AF, regardless of the degree of INR control. DOAC-treated patients had 22-27% lower risk of stroke or systemic embolism versus warfarin across various time-in-therapeutic range ratios.
American Journal of Cardiology, 2020.
Australian research has shown enablers diabetes screening interventions in community pharmacies include qualities of a pharmacy champion and active staff engagement, and ease of implementation related to the number of working pharmacists and other staff. Engagement with consumers and doctors, and consumer demand are other key drivers.
Research in Social and Administrative Pharmacy, 29 December 2020.
Excessive and inappropriately prolonged use of PPIs is associated with a broad range of adverse effects. Education of provider and patient, stewardship, and motivation are key to appropriate use of PPIs for the right indications. Deprescribing the PPI may be attempted following discussion with the patient. Approaches include stopping the drug, reducing the dose or using “on-demand” therapy after completing the course of treatment for the specific indication.
Journal of Post-Acute and long-Term Care Medicine 2021;22:15-22.