Phân tích thực trạng kê đơn thuốc chống đông trên bệnh nhân ngoại trú tại Bệnh viện Tim Hà Nội

Abstract

Objective: To analyze the clinical characteristics of outpatients prescribed anticoagulants and assess the current prescribing practices of anticoagulant therapy at Hanoi Heart Hospital. Subject and method: A retrospective descriptive study was conducted on outpatients who were prescribed anticoagulants at Facility 1 of Hanoi Heart Hospital from January 2022 to December 2022. Stratified sampling was employed based on the monthly number of outpatient visits. Data were collected from outpatient medical records. Result: A total of 385 patients, representative of the outpatient population at the hospital, were included in the study. The mean age of the patients was 62.0 ± 12 years. The majority of patients (70.2%) were treated with vitamin K antagonists (VKA). The two most common indications for anticoagulant therapy were atrial fibrillation and mechanical heart valves, accounting for over 95% of the study population. Among patients prescribed direct oral anticoagulants (DOAC), 72.7% received appropriate dosing. Documented drug-related problems (DRPs) included failure to adjust dosage according to renal function and underdosing. For patients on VKA therapy, 82.0% of dose decisions were appropriate. No statistically significant difference was observed between target INR groups. Reported adverse events included minor bleeding (12.7%), clinically significant bleeding requiring intervention or hospitalization (7%), and thromboembolic events (2.1%). Conclusion: Anticoagulant use in the outpatient setting requires close monitoring and individualized dose adjustment to ensure treatment efficacy and minimize adverse events.