DOAC dosing alerts corrected only one-third of errors

This post hoc analysis characterizes why asynchronous EHR notifications about inappropriate DOAC dosing frequently fail to prompt correction and what clinical anchors drive prescriber inaction, informing antithrombotic stewardship design.

apixabanrivaroxabandirect oral anticoagulantsclinical decision supportEHR alertsanticoagulation stewardshipatrial fibrillationpharmacist prescribingdosing errorsimplementation science Cardiology / Anticoagulation

Background Information

Tailored alerts improve correction of DOAC dosing errors.

Inappropriate dosing of direct oral anticoagulants (DOACs) is linked to severe outcomes like bleeding and hospitalization, making it crucial to understand correction efforts. Clinicians responded to electronic notifications, correcting 32.7% of inappropriate DOAC doses, with pharmacists documenting reasons for non-adjustments more often (90.5%) than prescribers (46.1%). Findings highlight the importance of tailored alerts to improve DOAC dosing corrections, potentially enhancing patient safety and evidence-based prescribing. Effective DOAC dosing correction hinges on tailored notification systems that consider key patient factors.

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Authors: Saraswat A, Smith SN, Dorsch MP, Fabbri M, Seagull J, Choi SY, Lanham M, Barnes GD

Citation: Saraswat A, Smith SN, Dorsch MP, et al. Clinical decision support tool evaluation: Correction of direct oral anticoagulant dosing errors by clinical pharmacists and physicians. Research and practice in thrombosis and haemostasis. 2026;10(6):106900. doi:10.1016/j.rpth.2026.106900

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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