Category: Federal Forum Posters
Purpose: Currently, there is a lack of clinical data regarding direct oral anticoagulant (DOAC) utilization in obese patients, and over 300 Veterans prescribed DOACs meeting obesity criteria have been identified within the Bay Pines VA Healthcare System. For these obese Veterans, there are concerns of lower drug trough concentrations and potentially increased probability of adverse events. The objective is to review Veterans with a body mass index (BMI) over 40 kilograms (kg) per meter squared or body weight greater than 120 kg with an active prescription for a DOAC and identify adverse events related to DOAC therapy.
Methods: A retrospective chart review will be conducted to identify adverse events in Veterans with obesity who were prescribed a DOAC. The study population will consist of Veterans with an active DOAC prescription as of July 18, 2018, identified through the Veterans Integrated Services Network 8 (VISN 8) Direct Oral Anticoagulant Population Management Tool. Hospitalized inpatient Veterans and Veterans who were prescribed a DOAC for venous thromboembolism (VTE) prophylaxis following orthopedic surgery or for an indication not approved by Veterans Affairs criteria for use (CFU) will be excluded. A sampling of up to 100 Veterans will be chosen for review. Chart review will be conducted of medical records up to 6 months prior to the study population identification date. Identification of adverse events will occur through manual chart review and/or usage of the “VISN 8 Pharmacy Benefit Management (PBM) Anticoagulation: Emergency Department (ED) Visits or Admissions for Bleeding or Clotting Events” report. Any adverse events with identifiable causes unrelated to DOACs will be noted.
Results: Not applicable
Conclusion: Not applicable
Gregory Martin– PGY1 Pharmacy Resident, Bay Pines VA Healthcare System, Seminole, FL