Drug Utilization, Safety, and Clinical Outcomes of Antithrombotic Agents: Insights from Real-World Hospital Data

Antithrombotic agents, including anticoagulants and antiplatelet drugs, are vital for preventing and managing thromboembolic events but pose risks of adverse drug reactions, drug-drug interactions, and dosing challenges. Limited real-world data from the United Arab Emirates warrant evaluation of prescribing and monitoring practices. This study aimed to assess prescribed daily doses of antithrombotic agents against World Health Organization-defined daily doses, evaluate related adverse drug reactions and drug-drug interactions, and analyze clinical outcomes.

A prospective observational study was conducted over seven months at a private academic hospital in Ajman, United Arab Emirates. Adult inpatients receiving antithrombotic therapy were included. Data on demographics, medications, laboratory results, adverse drug reactions, and drug-drug interactions were collected. The World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose methodology was applied.

Of 130 patients screened, 100 were included. Antiplatelet drugs were prescribed to 67% and anticoagulants to 33%, with enoxaparin being the most frequent agent. Deviations from World Health Organization-defined daily doses were common, including overprescription of enoxaparin and aspirin and underdosing of apixaban. Adverse drug reactions occurred in 17% of patients, most commonly hematuria and thrombocytopenia; all were mild and 90% were preventable. Drug-drug interactions occurred in 10%, mainly pharmacodynamic, with 67% classified as major. Monitoring of coagulation parameters was inconsistent, with most patients not achieving therapeutic targets.

The study revealed significant dosing variability, frequent adverse drug reactions and drug-drug interactions, and inadequate monitoring. Enhanced adherence to dosing guidelines and improved medication safety practices are essential to optimize outcomes in antithrombotic therapy.