Research Highlights Dosing Challenges of Common Anticoagulants in Underserved Communities

Blood thinning medications, known as anticoagulants, are frequently prescribed to prevent potentially fatal blood clots. Among them, direct oral anticoagulants (DOACs) have become a popular alternative to traditional medications like warfarin due to their ease of use and improved safety profiles. DOACs are used to treat various conditions affecting the blood vessels, heart, and lungs. However, their effectiveness highly depends on proper dosing and consistent monitoring, which can be challenging in underserved areas.

Incorrect dosing, insufficient patient monitoring, and harmful drug interactions can lead to serious and often preventable complications such as increased bleeding or blood clots. These adverse outcomes raise the risk of stroke, heart attack, or pulmonary embolism. Sara Rogers, PharmD, a clinical assistant professor at Texas A&M University, emphasizes that medication errors with DOACs can have significant consequences.

Research conducted by Rogers and her team, including Bader Alghamdi from Saudi Arabia, focused on how these medications are prescribed in a Texas clinic serving underserved populations. They found that while DOACs are increasingly preferred over warfarin for their effectiveness and safety—reducing risks of systemic embolism and bleeding—there are notable issues in their appropriate use. Specifically, during the study period, 16% of patients received the wrong dose because kidney function was not adequately considered. Additionally, severe liver disease patients were prescribed DOACs despite contraindications, and harmful drug interactions, particularly unnecessary aspirin use alongside DOACs, were common.

Most concerning was that in about two-thirds of cases, patients took aspirin with a DOAC unnecessarily, increasing bleeding risks and potential hospitalization. These findings highlight the need for structured anticoagulation management programs, especially in resource-limited settings, to improve safety and efficacy. Rogers and Alghamdi advocate for implementing stewardship initiatives to assist healthcare providers in underserved clinics.

The study, published in Scientific Reports, underscores the importance of proper guidelines adherence and patient monitoring to optimize anticoagulant therapy in vulnerable communities.

Source: https://medicalxpress.com/news/2025-10-dosing-common-anticoagulant-underserved-areas.html