Table 3.
Characteristics of Inappropriate Prescriptions
| Drug Group; No. (%) of Reasons* | |||
|---|---|---|---|
|
| |||
| Characteristic | Dabigatran (n = 39) | Rivaroxaban (n = 58) | Total (n = 97) |
| Nonapproved use | 4 (10) | 45 (78) | 49 (50.5) |
| Hip resurfacing or knee debridement | 0 (0) | 13 (22) | 13 (13.4) |
| Hip fracture | 0 (0) | 10 (17) | 10 (10.3) |
| Other fracture | 0 (0) | 11 (19) | 11 (11.3) |
| Orthopedic use without fracture | 0 (0) | 5 (9) | 5 (5.2) |
| Pulmonary embolism | 0 (0) | 2† (3) | 2† (2.1) |
| Bioprosthetic heart valve | 2 (5) | 0 (0) | 2 (2.1) |
| DVT treatment | 1 (3) | 0 (0) | 1 (1.0) |
| DVT prophylaxis (no THA or TKA) | 1 (3) | 0 (0) | 1 (1.0) |
| Other | 0 (0) | 4 (7) | 4 (4.1) |
|
| |||
| Concomitant anticoagulant | |||
| Prescribed but not administered | 11 (28) | 6 (10) | 17 (17.5) |
| Prescribed and administered | 2 (5) | 3 (5) | 5 (5.2) |
|
| |||
| Inappropriate transition from anticoagulant | 7 (18) | 0 (0) | 7 (7.2) |
|
| |||
| Dose high | 8 (21) | 1 (2) | 9 (9.3) |
|
| |||
| Dose low | 4 (10) | 0 (0) | 4 (4.1) |
|
| |||
| Renal failure | 2 (5) | 3 (5) | 5 (5.2) |
|
| |||
| Contraindicated drug interaction | 1 (3) | 0 (0) | 1 (1.0) |
DVT = deep vein thrombosis, THA = total hip arthroplasty, TKA = total knee arthroplasty.
*
Overall, 97 reasons for inappropriate prescribing were identified among a total of 91 prescriptions that were classified as inappropriate (some prescriptions were inappropriate for more than one reason).
†
At the time of data collection, rivaroxaban was not approved for treatment of pulmonary embolism (it was approved later, in 2013); therefore, although these 2 cases occurred after the release of the EINSTEIN-PE study results25 but before Health Canada approval, they were classified as nonapproved usage.