Čes. slov. farm. 2024, 73(1):22-26 | DOI: 10.36290/csf.2024.004
Direct oral anticoagulants from the perspective of Czech pharmacists - opinions, attitudes, confidence, and patient education during dispensing in a pharmacy
- Katedra sociální a klinické farmacie, Farmaceutická fakulta Univerzity Karlovy v Hradci Králové
Introduction and Aim: Pharmacists play an important role in the management of anticoagulation therapy, therefore good knowledge and confidence in care of patients treated with anticoagulation are essential. The aim of this study was to analyse the opinions and attitudes of pharmacists in the Czech Republic towards direct oral anticoagulants (DOACs), their perception of the benefits and risks of DOACs, and the position of pharmacists in educating patients about the basic principles of DOAC treatment in the context of dispensing these medicines in pharmacies.
Methods: An online anonymous questionnaire survey conducted in 2021 among pharmacists of three specific District Pharmacists Associations of the Czech Chamber of Pharmacy. The questionnaire included 32 open- and closed-ended questions, and questions for reporting of the level of agreement using a Likert scale. Descriptive statistics, parametric and non-parametric tests were used to evaluate the data.
Results: A total of 162 pharmacists participated (14% return rate), 139 of whom dispensed medicines in a pharmacy in the last year. Respondents working in pharmacies located in any health centre and in hospital pharmacies reported dispensing DOACs more frequently (p < 0.001). The majority of respondents (73%) felt completely or rather confident in providing expert information regarding DOACs. Higher confidence was associated with respondents working in hospital pharmacies or pharmacies located in health centres (p < 0.05), working in clinical pharmacy wards (p < 0.05) and being more likely to dispense DOACs in the pharmacy (p < 0.001). Higher confidence was related to the areas pharmacists discussed with patients during DOAC dispensing, e.g., reasons for using DOACs or how to administer.
Conclusion: The frequency of dispensing DOACs, type of pharmacy, and working as clinical pharmacist influenced respondents' confidence towards DOACs. Confidence may have influenced the course of DOAC dispensing in the pharmacy. Consolidating the pharmacist's position in patient education during DOAC treatment and strengthening pharmacists' confidence in dispensing DOACs should be therefore considered.
Keywords: pharmacists, DOACs, attitude, opinions, education.
Accepted: March 19, 2024; Published: March 19, 2024 Show citation
ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- Matýšková M, Michalcová J, Penka M. Antitrombotika dnes. Vnitř Lék. 2018;64(5):565-74.
Go to original source...
- Papastergiou J, Kheir N, Ladova K, et al. Pharmacists' confidence when providing pharmaceutical care on anticoagulants, a multinational survey. Int J Clin Pharm. 2017;39(6):1282-90.
Go to original source...
Go to PubMed...
- Maly J, Dvorackova S, Zimcikova E, et al. Patterns in anticoagulant utilization in the Czech Republic during 2007-2017. J Thromb Thrombolysis. 2019;47(2):305-11.
Go to original source...
Go to PubMed...
- Clarkesmith DE, Lip GYH, Lane DA. Patients' experiences of atrial fibrillation and non-vitamin K antagonist oral anticoagulants (NOACs), and their educational needs: A qualitative study. Thromb Res. 2017;153:19-27.
Go to original source...
Go to PubMed...
- Steffel J, Collins R, Antz M, et al. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. Europace. 2021;23(10):1612-76.
Go to original source...
Go to PubMed...
- Hamedi N, da Costa FA, Horne R, et al. How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants? Int J Clin Pharm. 2017;39(6):1273-81.
Go to original source...
Go to PubMed...
- Tan SL, Yong ZY, Liew JES, et al. How confident are pharmacists in providing pharmaceutical care on anticoagulants? A cross-sectional, self-administered questionnaire study in Borneo, Malaysia. J Pharm Policy Pract. 2021;14(1):97.
Go to original source...
Go to PubMed...
- Státní ústav pro kontrolu léčiv. [Internet]. Databáze léků. [cited 2022 Feb 23]. Available from: https://www.sukl.cz/modules/medication/search.php.
- Státní ústav pro kontrolu léčiv. [Internet]. Databáze lékáren. [cited 2022 Feb 23]. Available from: https://prehledy.sukl.cz/prehledy.html#/lekarny.
- Capiau A, Mehuys E, Dhondt E, et al. Physicians' and pharmacists' views and experiences regarding use of direct oral anticoagulants in clinical practice. Br J Clin Pharmacol. 2022;88(4):1856-65.
Go to original source...
Go to PubMed...
- Ozaki AF, Choi AS, Le QT, et al. Real-World Adherence and Persistence to Direct Oral Anticoagulants in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes. 2020;13(3):e005969.
Go to original source...
Go to PubMed...
- Jani YH, Hirani B, Livingstone C. Evaluation of patients' knowledge about oral anticoagulant medicines and use of alert cards by community pharmacists. Int J Clin Pharm. 2021;43(1):203-11.
Go to original source...
Go to PubMed...
- El-Bardissy A, Elewa H, Khalil A, et al. Assessing Pharmacists Knowledge and Attitude Toward the Direct Oral Anticoagulants in Qatar. Clin Appl Thromb Hemost. 2020;26:1076029620933946.
Go to original source...
Go to PubMed...
- Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139-51.
Go to original source...
Go to PubMed...
- Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883-91.
Go to original source...
Go to PubMed...
- Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981-92.
Go to original source...
Go to PubMed...