Residents and Fellows Research in Progress
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction:
The FDA manufacturers label recommends against use of most direct oral anticoagulants (DOACs) in Child Pugh (CP) Class B (moderate) and C (severe) end stage liver disease (ESLD). The exception is apixaban, with approved use in CP Class B, but not CP Class C. Although DOACs are not recommended in moderate to severe ESLD, they remain the most convenient option for anticoagulation and are used in practice. When DOACs are utilized outside of FDA labeling recommendations dosing is not standardized and varies widely in the available literature. The aim of this study is to describe the current dosages of DOACs being used in ESLD CP Class B or C in clinical practice at academic medical centers across the United States.
Research Question or Hypothesis: To describe commonly used dosages of DOACs (apixaban, rivaroxaban, edoxaban, dabigatran) in ESLD CP Class B or C at academic medical centers.
Study Design: Qualitative study with semi-structured interviews
Methods: This qualitative study will employ semi-structured interviews with pharmacists at academic medical centers to assess dosages of DOACs being utilized in patients with ESLD CP Class B and C. Interviews will be performed using an interview guide, conducted and recorded via zoom, and last approximately fifteen to thirty minutes. Interviews will be transcribed, and thematic analysis performed. The primary objective is to examine the dosages of DOACs outside of FDA labeling for patients with CP Class B and C. The secondary objectives are to assess if indication and/or patient specific factors play a role in the selection of DOAC dose.
Results: in progress
Conclusion: in progress
Presenting Author
Taylor Fallin PharmDUniversity of Oklahoma College of Pharmacy
Authors
Kiya Bennett Pharm.D., BCPS
University of Oklahoma Health Science Center College of Pharmacy
Tammy Lambert PharmD, PhD
University of Oklahoma College of Pharmacy
Corey Guidry PharmD, BCPS
University of Oklahoma
Jordan Perrine Pharm.D., MBA, BCPS, BCCCP
University of Oklahoma Health Science Center College of Pharmacy