Oral anticoagulation in primary care

Rev Esp Sanid Penit. 2017 Jun;19(1):19-34. doi: 10.4321/S1575-06202017000100004.

Abstract

Oral anticoagulant therapy is currently widespread in the population and primary care plays an important role in its control in Spain. Younger populations, such as those in prisons, often require this treatment for reasons other than atrial fibrillation, often in relation to valvular or congenital or acquired hypercoagulability situations. The possibility of obtaining the INR by portable coagulometers has allowed primary care physicians to tackle the indication of this therapy and the control of these patients in coordination with haematology services. The emergence of new therapeutic alternatives (Dabigatran, Rivaroxaban, Apixaban and Edoxaban, the so called "ACOD") has permitted the expansion of options for oral anticoagulation in some cases, since they do not require systematic monitoring of their effect and interact with far fewer drugs than their predecessors, although there are still restrictions by the health authorities on their widespread use. This article reviews the different indications of oral anticoagulant therapy according to the new recommendations as well as the clinical scenarios in which it should be used.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Ambulatory Care
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Contraindications, Drug
  • Drug Monitoring
  • Heart Valve Diseases / complications
  • Heart Valve Diseases / drug therapy*
  • Humans
  • Primary Health Care*
  • Spain
  • Stroke / etiology
  • Stroke / prevention & control*
  • Thromboembolism / drug therapy
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control*

Substances

  • Anticoagulants