UNASSIGNED: Background Non- @entity2067 oral anticoagulants (NOACs) became available in the Netherlands in 2008, providing another antithrombotic treatment besides @entity2067 antagonists (VKAs) and antiplatelet agents (APAs). Objective To describe the patterns of antithrombotic drug use between 2008 and 2013 by examination of dispensing data form community pharmacies in the Netherlands; to determine the concomitant use of NOACs with VKAs and APAs and switching between the drug classes; and to compare adherence to NOACs with adherence to APAs. Setting An observational retrospective study was conducted using routinely collected dispensing data from Dutch community pharmacies. Methods For each calendar year, the numbers of NOAC, VKA, and @entity22518 users were calculated. Adherence was determined for NOACs and APAs by the percentage of days covered by medication ( @entity22813 ). Information on the prescribed daily dose of VKAs was unavailable. Main outcome measures Comparison of age, sex, and co-medications of users of the three drug classes; concomitant use of different antithrombotic drug classes and switching between these in each year; and mean @entity22813 and percentages of all users with a @entity22813 above 80  %. Results NOAC use increased during the study period to 29,687 users in 2013. In that year there were 484,024 VKA users and 1313,032 @entity22518 users. Compared with users of VKAs, NOAC users were slightly younger and more frequently used antiarrhythmic drugs and beta blockers as co-medications. Substantial numbers of @entity1 were dispensed potentially harmful combinations in 2013: 820 subjects were dispensed NOACs together with VKAs, and 684 subjects were dispensed NOACs, VKAs, and APAs concomitantly. Mean adherence to NOACs was 84.2  % compared with 87.3  % to @entity22518 . One in four @entity15796 users had a @entity22813 lower than 80  % compared with one in five @entity22518 users. Conclusion Our findings show increasing use of NOACs by outpatients. The number of @entity1 taking potentially harmful combinations of antithrombotic drugs was substantial. Adherence to NOACs in daily practice may be suboptimal to prevent @entity715 events.

Trends in antithrombotic drug use and adherence to non- XXXX oral anticoagulants in the Netherlands.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity22813 :: ('MESH:C537181', 'Disease') :: ['PDC'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K'] @entity15796 :: ('MESH:C065145', 'Chemical') :: ['NOAC'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombotic'] @entity22518 :: ('CHEBI:53713', 'Chemical') :: ['APA']
@entity2067 :: (MESH:D014812,Chemical) :: ['vitamin K']
