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Year : 2021  |  Volume : 11  |  Issue : 3  |  Page : 177-181

Cross-sectional survey of anticoagulant use among specialist physicians with a focus on direct anticoagulants

1 Department of Medical Oncology, Dayanand Medical College, Ludhiana, Punjab, India
2 Department of Nephrology, Dayanand Medical College, Ludhiana, Punjab, India
3 Department of Periodontics, Christian Dental College, Ludhiana, Punjab, India
4 New Medical College and Hospital, Kota, Rajasthan, India
5 Department of Internal Medicine, New Medical College, Kota, Rajasthan, India
6 Department of Clinical Hematology and Oncology, Dayanand Medical College, Kota, Rajasthan, India
7 Department of Neurology, Dayanand Medical College, Kota, Rajasthan, India

Correspondence Address:
Suvir Singh
Department of Clinical Hematology and Stem Cell Transplantation, Dayanand Medical College and Hospital, Ludhiana - 141 001, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijabmr.ijabmr_135_21

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Introduction: Direct oral anticoagulants (DOACs) have been available for clinical use since 2010 and offer the advantages of a lower bleeding risk with similar efficacy compared to Vitamin K antagonists (VKAs). However, no data is available on practice patterns anticoagulation usage and determinants of the same among physicians in India. Methods: A cross-sectional survey was conducted using Google Forms comprising of 24 questions in 4 categories on baseline information, practice details, knowledge, and outlook. Results: A total of 412 physicians were contacted, of which complete responses were received from 50 (12%). Majority had a subspecialist (58%) or a specialist (32%) qualification, with 54% working in a medical college. VKAs were the preferred first-line agent for 46%, with the most common perceived disadvantage being need of regular monitoring. The absence of regular blood testing was the most prominent advantage attributed to novel oral anticoagulants (NOACs) by 76% participants. Equivalent number of participants perceived efficacy to be similar in both groups, and 86% indicated NOACs to have better safety. Most participants responded to knowledge-based questions correctly and cited high costs of DOACs as the most common barrier to clinical use (78%). Conclusions: Our survey indicates VKAs as the preferred first-line agents despite perceived disadvantages. Among specialist physicians, high drug costs and not lack of knowledge or familiarity appear to be predominant factors precluding more frequent use of NOACs.

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