An MHRA Drug Safety Alert in June 2020 highlighted the need to review patients on a DOAC to ensure correct dosing, ensure patients with renal impairment receive an appropriate dose and monitor renal function during treatment to ensure dose remains appropriate. Due to the large number of patients receiving a DOAC in Morecambe Bay CCG and the complexity of the parameters needed to be collected to effectively audit this, a semi-automated digital process was created to enable data download from the GP EMIS system into an Excel spreadsheet for analysis.
Objectives were:
1. To assess whether patients across Morecambe Bay CCG are prescribed DOACs in line with licensed indications
2. To assess whether the dose of DOAC is appropriate based on patient’s weight, age and renal function
3. To assess whether appropriate monitoring has been undertaken for patients prescribed DOACs, given their renal function, in line with MHRA alert June 2020
4. To identify commonly occurring issues in the prescribing of DOACs to inform future educational events and/or development of tools and resources to address these issues.
The long term aim is to embed a culture of safer DOAC prescribing, but data from the first re-audit after six months has already shown a significant improvement.
