Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care
Background Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results ha...
Gespeichert in:
| Veröffentlicht in: | British journal of general practice 2021-02, Vol.71 (703), p.E134-E139 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | E139 |
|---|---|
| container_issue | 703 |
| container_start_page | E134 |
| container_title | British journal of general practice |
| container_volume | 71 |
| creator | Ferrat, Emilie Fabre, Julie Galletout, Philippe Boutin, Emmanuelle Le Breton, Julien Renard, Vincent Frappe, Paul Bastuji-Garin, Sylvie |
| description | Background
Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results have been reported about the factors independently associated with inappropriate dosing.
Aim
To describe inappropriate prescriptions of DOACs among patients in the CACAO French nationwide general practice cohort, and to identify the factors independently associated with inappropriate DOAC doses.
Design and setting
Cross sectional baseline analysis of the CACAO French national multicentre prospective cohort of adult patients in primary cam receiving an oral anticoagulant who were recruited between April and October 2014.
Method
A total of 1111 patients from the CACAO cohort who received a DOAC for NVAF were included in this study Inappropriate prescriptions of DOACs were described (inappropriate dosage, contraindications. non-indications, interactions. and non compliance with the precautions for use). Multivariate logistic models were used to investigate factors associated with inappropriate DOAC dosing (under-dosing and over-dosing).
Results
Overall, 438 patients (39.4%) received at least one inappropriate DOAC prescription. The most common inappropriate prescription was inappropriate dosage (n= 374, 317%) particularly under dosing (n = 348, 31.3%). Multivariate analysts revealed that factors independently associated with under dosing were older age, prescription of apixaban or dabigatran, and a CHA2DS2-VASc score >= 2 vs. a score =1. Factors with over-dosing were kidney failure, a HAS-BLED score >= 3, and older age.
Conclusion
The appropriateness of DOAC prescribing for NVAF can be improved, especially in older patients, and in patients with kidney failure. a higher risk of ischaemic stroke, and/or a higher risk of bleeding. GPs have a key role in increasing the proportion of appropriate DOAC prescriptions via informational, educational, and/or management strategies. |
| doi_str_mv | 10.3399/bjgp20X714005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_33495204</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2481109292</sourcerecordid><originalsourceid>FETCH-LOGICAL-c449t-d3723f528d955bf226f6f47f04f552625d6d18e4d0f7e7b438d081228a78ab773</originalsourceid><addsrcrecordid>eNqNkk2P0zAQhiMEYrsLR67IEhcQCow_EicckKpol12p0l5A4hY5jt24SuNgO131b_ELcdpSsXvi5K9n3pl5PUnyBsMnSsvyc7NZjwR-cswAsmfJAjNepBlh5HmygDKHFOeMXiSX3m8ACMkxvEwuKGVlRoAtkt93gxhHZ0dnRFCoNU7JgKwTPRJDMNKK9dTHHRqd8tKZMRg7eGQGNIpg1BA8ejChQ4Md0p3odxF2SISo1iNtGmf6XswhX5B01vvUR_l4PMiLfu-NR1aj0Cl049QgO1Qtq-U9krazLiAfpnZ_SObMVrg9ksKpV8kLLXqvXp_Wq-THzfX36jZd3X-7q5arVDJWhrSlnFCdkaIts6zRsXWda8Y1MJ1lJCdZm7e4UKwFzRVvGC1aKDAhheCFaDinV8nXo-44NVvVythstKU-lVJbYerHL4Pp6rXd1bxgOc0gCnw4CnRPwm6Xq3q-AxpRKPkOR_b9KZmzvyblQ701Xqro3qDs5GvCCoyhJCWJ6Lsn6MZOLro5UyWQHCCfBdMjdfDdKX2uAEM9T079aHIi__bfbs_031GJwMcj8KAaq72Mny_VGYM5KcPZnB1gNq_4f7oy4TAklZ2GQP8Abs7juA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2490260061</pqid></control><display><type>article</type><title>Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care</title><source>MEDLINE</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Ferrat, Emilie ; Fabre, Julie ; Galletout, Philippe ; Boutin, Emmanuelle ; Le Breton, Julien ; Renard, Vincent ; Frappe, Paul ; Bastuji-Garin, Sylvie</creator><creatorcontrib>Ferrat, Emilie ; Fabre, Julie ; Galletout, Philippe ; Boutin, Emmanuelle ; Le Breton, Julien ; Renard, Vincent ; Frappe, Paul ; Bastuji-Garin, Sylvie</creatorcontrib><description>Background
Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results have been reported about the factors independently associated with inappropriate dosing.
Aim
To describe inappropriate prescriptions of DOACs among patients in the CACAO French nationwide general practice cohort, and to identify the factors independently associated with inappropriate DOAC doses.
Design and setting
Cross sectional baseline analysis of the CACAO French national multicentre prospective cohort of adult patients in primary cam receiving an oral anticoagulant who were recruited between April and October 2014.
Method
A total of 1111 patients from the CACAO cohort who received a DOAC for NVAF were included in this study Inappropriate prescriptions of DOACs were described (inappropriate dosage, contraindications. non-indications, interactions. and non compliance with the precautions for use). Multivariate logistic models were used to investigate factors associated with inappropriate DOAC dosing (under-dosing and over-dosing).
Results
Overall, 438 patients (39.4%) received at least one inappropriate DOAC prescription. The most common inappropriate prescription was inappropriate dosage (n= 374, 317%) particularly under dosing (n = 348, 31.3%). Multivariate analysts revealed that factors independently associated with under dosing were older age, prescription of apixaban or dabigatran, and a CHA2DS2-VASc score >= 2 vs. a score =1. Factors with over-dosing were kidney failure, a HAS-BLED score >= 3, and older age.
Conclusion
The appropriateness of DOAC prescribing for NVAF can be improved, especially in older patients, and in patients with kidney failure. a higher risk of ischaemic stroke, and/or a higher risk of bleeding. GPs have a key role in increasing the proportion of appropriate DOAC prescriptions via informational, educational, and/or management strategies.</description><identifier>ISSN: 0960-1643</identifier><identifier>EISSN: 1478-5242</identifier><identifier>DOI: 10.3399/bjgp20X714005</identifier><identifier>PMID: 33495204</identifier><language>eng</language><publisher>LONDON: Royal Coll General Practitioners</publisher><subject><![CDATA[Administration, Oral ; Adult ; Aged ; Anticoagulants ; Anticoagulants - therapeutic use ; Atrial Fibrillation - drug therapy ; Brain Ischemia ; Cardiac arrhythmia ; Cohort analysis ; Cohort Studies ; Cross-Sectional Studies ; Drug dosages ; General & Internal Medicine ; Humans ; Inappropriate Prescribing - prevention & control ; Life Sciences ; Life Sciences & Biomedicine ; Medication ; Medicine, General & Internal ; Pharmaceutical sciences ; Prescription drugs ; Prescriptions ; Primary care ; Primary Health Care ; Prospective Studies ; Santé publique et épidémiologie ; Science & Technology ; Stroke - prevention & control]]></subject><ispartof>British journal of general practice, 2021-02, Vol.71 (703), p.E134-E139</ispartof><rights>The Authors.</rights><rights>Copyright Royal College of General Practitioners Feb 2021</rights><rights>Attribution</rights><rights>The Authors 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000614152600007</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c449t-d3723f528d955bf226f6f47f04f552625d6d18e4d0f7e7b438d081228a78ab773</citedby><cites>FETCH-LOGICAL-c449t-d3723f528d955bf226f6f47f04f552625d6d18e4d0f7e7b438d081228a78ab773</cites><orcidid>0000-0002-7350-2824</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846350/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846350/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33495204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03784097$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferrat, Emilie</creatorcontrib><creatorcontrib>Fabre, Julie</creatorcontrib><creatorcontrib>Galletout, Philippe</creatorcontrib><creatorcontrib>Boutin, Emmanuelle</creatorcontrib><creatorcontrib>Le Breton, Julien</creatorcontrib><creatorcontrib>Renard, Vincent</creatorcontrib><creatorcontrib>Frappe, Paul</creatorcontrib><creatorcontrib>Bastuji-Garin, Sylvie</creatorcontrib><title>Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care</title><title>British journal of general practice</title><addtitle>BRIT J GEN PRACT</addtitle><addtitle>Br J Gen Pract</addtitle><description>Background
Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results have been reported about the factors independently associated with inappropriate dosing.
Aim
To describe inappropriate prescriptions of DOACs among patients in the CACAO French nationwide general practice cohort, and to identify the factors independently associated with inappropriate DOAC doses.
Design and setting
Cross sectional baseline analysis of the CACAO French national multicentre prospective cohort of adult patients in primary cam receiving an oral anticoagulant who were recruited between April and October 2014.
Method
A total of 1111 patients from the CACAO cohort who received a DOAC for NVAF were included in this study Inappropriate prescriptions of DOACs were described (inappropriate dosage, contraindications. non-indications, interactions. and non compliance with the precautions for use). Multivariate logistic models were used to investigate factors associated with inappropriate DOAC dosing (under-dosing and over-dosing).
Results
Overall, 438 patients (39.4%) received at least one inappropriate DOAC prescription. The most common inappropriate prescription was inappropriate dosage (n= 374, 317%) particularly under dosing (n = 348, 31.3%). Multivariate analysts revealed that factors independently associated with under dosing were older age, prescription of apixaban or dabigatran, and a CHA2DS2-VASc score >= 2 vs. a score =1. Factors with over-dosing were kidney failure, a HAS-BLED score >= 3, and older age.
Conclusion
The appropriateness of DOAC prescribing for NVAF can be improved, especially in older patients, and in patients with kidney failure. a higher risk of ischaemic stroke, and/or a higher risk of bleeding. GPs have a key role in increasing the proportion of appropriate DOAC prescriptions via informational, educational, and/or management strategies.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Brain Ischemia</subject><subject>Cardiac arrhythmia</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Cross-Sectional Studies</subject><subject>Drug dosages</subject><subject>General & Internal Medicine</subject><subject>Humans</subject><subject>Inappropriate Prescribing - prevention & control</subject><subject>Life Sciences</subject><subject>Life Sciences & Biomedicine</subject><subject>Medication</subject><subject>Medicine, General & Internal</subject><subject>Pharmaceutical sciences</subject><subject>Prescription drugs</subject><subject>Prescriptions</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Prospective Studies</subject><subject>Santé publique et épidémiologie</subject><subject>Science & Technology</subject><subject>Stroke - prevention & control</subject><issn>0960-1643</issn><issn>1478-5242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkk2P0zAQhiMEYrsLR67IEhcQCow_EicckKpol12p0l5A4hY5jt24SuNgO131b_ELcdpSsXvi5K9n3pl5PUnyBsMnSsvyc7NZjwR-cswAsmfJAjNepBlh5HmygDKHFOeMXiSX3m8ACMkxvEwuKGVlRoAtkt93gxhHZ0dnRFCoNU7JgKwTPRJDMNKK9dTHHRqd8tKZMRg7eGQGNIpg1BA8ejChQ4Md0p3odxF2SISo1iNtGmf6XswhX5B01vvUR_l4PMiLfu-NR1aj0Cl049QgO1Qtq-U9krazLiAfpnZ_SObMVrg9ksKpV8kLLXqvXp_Wq-THzfX36jZd3X-7q5arVDJWhrSlnFCdkaIts6zRsXWda8Y1MJ1lJCdZm7e4UKwFzRVvGC1aKDAhheCFaDinV8nXo-44NVvVythstKU-lVJbYerHL4Pp6rXd1bxgOc0gCnw4CnRPwm6Xq3q-AxpRKPkOR_b9KZmzvyblQ701Xqro3qDs5GvCCoyhJCWJ6Lsn6MZOLro5UyWQHCCfBdMjdfDdKX2uAEM9T079aHIi__bfbs_031GJwMcj8KAaq72Mny_VGYM5KcPZnB1gNq_4f7oy4TAklZ2GQP8Abs7juA</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Ferrat, Emilie</creator><creator>Fabre, Julie</creator><creator>Galletout, Philippe</creator><creator>Boutin, Emmanuelle</creator><creator>Le Breton, Julien</creator><creator>Renard, Vincent</creator><creator>Frappe, Paul</creator><creator>Bastuji-Garin, Sylvie</creator><general>Royal Coll General Practitioners</general><general>Royal College of General Practitioners</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7350-2824</orcidid></search><sort><creationdate>20210201</creationdate><title>Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care</title><author>Ferrat, Emilie ; Fabre, Julie ; Galletout, Philippe ; Boutin, Emmanuelle ; Le Breton, Julien ; Renard, Vincent ; Frappe, Paul ; Bastuji-Garin, Sylvie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-d3723f528d955bf226f6f47f04f552625d6d18e4d0f7e7b438d081228a78ab773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Brain Ischemia</topic><topic>Cardiac arrhythmia</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Cross-Sectional Studies</topic><topic>Drug dosages</topic><topic>General & Internal Medicine</topic><topic>Humans</topic><topic>Inappropriate Prescribing - prevention & control</topic><topic>Life Sciences</topic><topic>Life Sciences & Biomedicine</topic><topic>Medication</topic><topic>Medicine, General & Internal</topic><topic>Pharmaceutical sciences</topic><topic>Prescription drugs</topic><topic>Prescriptions</topic><topic>Primary care</topic><topic>Primary Health Care</topic><topic>Prospective Studies</topic><topic>Santé publique et épidémiologie</topic><topic>Science & Technology</topic><topic>Stroke - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ferrat, Emilie</creatorcontrib><creatorcontrib>Fabre, Julie</creatorcontrib><creatorcontrib>Galletout, Philippe</creatorcontrib><creatorcontrib>Boutin, Emmanuelle</creatorcontrib><creatorcontrib>Le Breton, Julien</creatorcontrib><creatorcontrib>Renard, Vincent</creatorcontrib><creatorcontrib>Frappe, Paul</creatorcontrib><creatorcontrib>Bastuji-Garin, Sylvie</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of general practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ferrat, Emilie</au><au>Fabre, Julie</au><au>Galletout, Philippe</au><au>Boutin, Emmanuelle</au><au>Le Breton, Julien</au><au>Renard, Vincent</au><au>Frappe, Paul</au><au>Bastuji-Garin, Sylvie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care</atitle><jtitle>British journal of general practice</jtitle><stitle>BRIT J GEN PRACT</stitle><addtitle>Br J Gen Pract</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>71</volume><issue>703</issue><spage>E134</spage><epage>E139</epage><pages>E134-E139</pages><issn>0960-1643</issn><eissn>1478-5242</eissn><abstract>Background
Direct oral anticoagulants (DOACs) account for an increasing proportion of prescriptions in patients with non-valvular atrial fibrillation (NVAF) in primary care. Inappropriate dosing of DOACs is a common problem, with under-dosing being a particular issue. However, conflicting results have been reported about the factors independently associated with inappropriate dosing.
Aim
To describe inappropriate prescriptions of DOACs among patients in the CACAO French nationwide general practice cohort, and to identify the factors independently associated with inappropriate DOAC doses.
Design and setting
Cross sectional baseline analysis of the CACAO French national multicentre prospective cohort of adult patients in primary cam receiving an oral anticoagulant who were recruited between April and October 2014.
Method
A total of 1111 patients from the CACAO cohort who received a DOAC for NVAF were included in this study Inappropriate prescriptions of DOACs were described (inappropriate dosage, contraindications. non-indications, interactions. and non compliance with the precautions for use). Multivariate logistic models were used to investigate factors associated with inappropriate DOAC dosing (under-dosing and over-dosing).
Results
Overall, 438 patients (39.4%) received at least one inappropriate DOAC prescription. The most common inappropriate prescription was inappropriate dosage (n= 374, 317%) particularly under dosing (n = 348, 31.3%). Multivariate analysts revealed that factors independently associated with under dosing were older age, prescription of apixaban or dabigatran, and a CHA2DS2-VASc score >= 2 vs. a score =1. Factors with over-dosing were kidney failure, a HAS-BLED score >= 3, and older age.
Conclusion
The appropriateness of DOAC prescribing for NVAF can be improved, especially in older patients, and in patients with kidney failure. a higher risk of ischaemic stroke, and/or a higher risk of bleeding. GPs have a key role in increasing the proportion of appropriate DOAC prescriptions via informational, educational, and/or management strategies.</abstract><cop>LONDON</cop><pub>Royal Coll General Practitioners</pub><pmid>33495204</pmid><doi>10.3399/bjgp20X714005</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7350-2824</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-1643 |
| ispartof | British journal of general practice, 2021-02, Vol.71 (703), p.E134-E139 |
| issn | 0960-1643 1478-5242 |
| language | eng |
| recordid | cdi_pubmed_primary_33495204 |
| source | MEDLINE; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Alma/SFX Local Collection |
| subjects | Administration, Oral Adult Aged Anticoagulants Anticoagulants - therapeutic use Atrial Fibrillation - drug therapy Brain Ischemia Cardiac arrhythmia Cohort analysis Cohort Studies Cross-Sectional Studies Drug dosages General & Internal Medicine Humans Inappropriate Prescribing - prevention & control Life Sciences Life Sciences & Biomedicine Medication Medicine, General & Internal Pharmaceutical sciences Prescription drugs Prescriptions Primary care Primary Health Care Prospective Studies Santé publique et épidémiologie Science & Technology Stroke - prevention & control |
| title | Inappropriate direct oral anticoagulant prescriptions in patients with non-valvular atrial fibrillation: cross-sectional analysis of the French CACAO cohort study in primary care |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-12T17%3A44%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Inappropriate%20direct%20oral%20anticoagulant%20prescriptions%20in%20patients%20with%20non-valvular%20atrial%20fibrillation:%20cross-sectional%20analysis%20of%20the%20French%20CACAO%20cohort%20study%20in%20primary%20care&rft.jtitle=British%20journal%20of%20general%20practice&rft.au=Ferrat,%20Emilie&rft.date=2021-02-01&rft.volume=71&rft.issue=703&rft.spage=E134&rft.epage=E139&rft.pages=E134-E139&rft.issn=0960-1643&rft.eissn=1478-5242&rft_id=info:doi/10.3399/bjgp20X714005&rft_dat=%3Cproquest_pubme%3E2481109292%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2490260061&rft_id=info:pmid/33495204&rfr_iscdi=true |