Evaluating the impact of a structured medication optimisation review on prescribing patterns and bleeding risk among patients prescribed direct oral anticoagulants (DOACs): a difference-in-differences study
SMORs can be delivered at scale and used to switch medications for a large proportion of people. There was no evidence of an increased risk of admissions for bleeding complications in AF patients following a large-scale switch from apixaban to edoxaban supported by SMORs. Such reviews could improve prescribing quality and patient safety by ensuring patients are on the most appropriate dose and choice of DOAC and lead to cost savings to health services (by facilitating a switch to a better value product) while not increasing risks for patients.
Authors
- Joanne Bateman
- Iain Buchan (ORCID: https://orcid.org/0000-0003-3392-1650)
- Elizabeth Camacho (ORCID: https://orcid.org/0000-0001-9574-7710)
- Ben Barr (ORCID: https://orcid.org/0000-0002-4208-9475)
- Konstantinos Daras (ORCID: https://orcid.org/0000-0002-4573-4628)
- Jennifer Downing (ORCID: https://orcid.org/0000-0001-7691-1167)
- O. W. Butters (ORCID: https://orcid.org/0000-0003-0354-8461)
- S. V. Lynch
Institutions
- University of Liverpool (GB)
- Countess of Chester Hospital NHS Foundation Trust (GB)
- Cheshire West and Chester (GB)
Publication Details
- Journal
- BMJ Open Quality
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1136/bmjoq-2025-003568
- Primary Topic
- Atrial Fibrillation Management and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institute for Health and Care Research
- Department of Health and Social Care
- Public Health England