The Anticoagulant Versus Warfarin Discussion

The Anticoagulant Versus Warfarin Discussion

Please provide a 1 page response elaborating on DOAC therapy vs warfarin for anticoagulation. Include cost considerations as well.

The article reviewed sought out patients who have atrial fibrillation and on anticoagulants. The purpose of the study is to clarify the knowledge of direct oral anticoagulant versus warfarin in patients with atrial fibrillation. The analysis of patient perspectives on direct oral anticoagulants prescribing practice and preference was reviewed. The Anticoagulant Versus Warfarin Discussion

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A convenience sampling was performed to conduct this study in which participants were interviewed via telephone or interviewed online. The most conveniently available participants are used in these samples. Qualitative researchers commonly use this convenience sampling or volunteers (Polit & Beck, 2021)The results of the 19 participants varied in their experience with direct oral anticoagulants. The main saturation of the theme focused on drug characteristics, costs, balance of risks and benefits and bleeding (Jarrar, 108) Based on the results of the study, not all participants were knowledgeable about various options for anticoagulation (Jarrar, 108) More qualitative studies need to be conducted to gather more information on the patient and clinician perspectives on this subject of prescribing direct oral anticoagulants for atrial fibrillation condition. The results of this study could encourage a change in practice by giving patients with atrial fibrillation options on their medication. Warfarin is a common medication and has received competition in recent years with direct oral anticoagulant medications. Practices should explore other options for patients that can be cost-effective and conducive to the patients safety and lifestyle.

Direct oral anticoagulants’ have an advantage over the warfarin treatment because of the short half life, fixed dosing and no monitoring requirement (Sikorska, 2017)Some disadvantages accompany these direct oral anticoagulants such as no reversal medication and those precautions in renal patients (Sikorska, 2017)The Anticoagulant Versus Warfarin Discussion

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Jarrar, R. (108). 79 Qualitative study on influences on anticoagulant prescribing for stroke prevention in atrial fibrillation. Heart, 1. https://doi.org/10.1136/heartjnl-2022-BCS.79
Polit, D. F., & Beck, C. T. (2021). Nursing research generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

Sikorska, J. (2017). Direct oral anticoagulants: A quick guide. National library of medicine, 12(1). https://doi.org/10.15420%2Fecr.2017%3A11%3A2

Thank you for sharing. Direct oral anticoagulants (DOACs) and warfarin are used in the treatment of atrial fibrillation. However, both medications have several differences. DOACs are rapid and short-acting agents, which makes it important to take all the doses as prescribed. Missing DOAC doses can expose a patient to inadequate protection against the formation of blood clots. They have a relatively low bleeding risk and a good safety profile (Kalani et al., 2019). Compared to warfarin, DOACs are not affected by alcohol or food and have fewer drug and supplement interactions. They do not require blood monitoring and have a rapid onset and off-set anticoagulant effect. DOACs are usually more expensive compared to warfarin because insurance companies cover their preferred DOACs. The administration of warfarin is once-per-day, while some DOACs require a dosing of twice a day, which increases the chance of non-compliance.

The antidotes for DOACs are minimal. For instance, there was no specific antidote for DOACs until 2015. In 2018, the FDA approved andexanet alfa, whose trade name is AndexXa, for the reversal of apixaban, and its efficacy is still being studied (Burn & Pirmohamed, 2018)The Anticoagulant Versus Warfarin Discussion. In the case of complications, some DOACs do not have FDA-approved antidotes. The anticoagulant effects of warfarin are reversed with the administration of vitamin K. DOACs are more effective and less likely to cause severe bleeding compared to warfarin. It is important to note that the risk of bleeding is present in both drugs (Vinogradova et al., 2018). The administration of DOACS depends on a patient’s kidney function and is generally contraindicated in end-stage renal disease patients. DOACs have become an attractive option for atrial fibrillation compared to warfarin.

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References

Burn, J., & Pirmohamed, M. (2018). Direct oral anticoagulants versus warfarin: is new always better than the old?. Open heart, 5(1), e000712.

Kalani, C., Awudi, E., Alexander, T., Udeani, G., & Surani, S. (2019). Evaluation of the efficacy of direct oral anticoagulants (DOACs) in comparison to warfarin in morbidly obese patients. Hospital practice, 47(4), 181-185.

Vinogradova, Y., Coupland, C., Hill, T., & Hippisley-Cox, J. (2018). Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. bmj, 362 The Anticoagulant Versus Warfarin Discussion