Dabigatran, a reversible thrombin inhibitor and novel oral anticoagulant (NOAC) became fully funded in New Zealand in 2011. The Best Practice Advocacy Centre New Zealand (bpacnz) published prescriber information on…
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The Compass Health Primary Health Organisation checked every patient prescribed the anticoagulant (blood thinner) dabigatran twice during 2014 and 2016. There was a big increase in patients prescribed dabigatran during this time. Kidney function needs to be monitored if dabigatran is being taken. Ninety-six (96%) percent of patients prescribed dabigatran were taking it for approved reasons and 90% of patients had their kidney function checked each year, which is recommended by treatment guidelines.
To assess annual renal function monitoring and clinical indications for use in patients prescribed dabigatran.
A quality improvement activity included all patients in the Compass Health Primary Health Organisation (PHO) prescribed dabigatran. Information recorded: demographics; indication for use; daily dose; height; weight; serum creatinine; and estimated glomerular filtration rate (eGFR).
The first audit occurred during July 2013 – May 2014, the second during May 2014 – October 2016.
Across the PHO, all patients prescribed dabigatran were reviewed: 941 patients and 1,564 respectively. At the time of the second pass audit, renal function monitoring improved from 88% to 90%, and 96% were prescribed dabigatran for an approved indication.
Results showed a continuing high level of renal function monitoring across the PHO in 90% of patients prescribed dabigatran. Practitioners were reminded to use creatinine clearance as a marker of renal function. Dabigatran was prescribed for an approved indication in 96% of patients. Our results are in line with recommended best practice and clinical guidelines.