Knowledge from a registry of oral anticoagulant prescriptions kept by clinical pharmacists in a neurovascular care unit: neurologist practices and the way pharmacists can secure prescriptions

Two classes of oral anti-coagulant (OAC) are available to reduce the risk of ischemic stroke: vitamin K antagonists (VKA) and direct oral anti-coagulants (DOA). Our goals were to evaluate current prescription practices in a neurovascular care unit (NCU), to inform discharged patients on their drug and to follow them up. A registry of 124 patients with an OAC prescription, was kept by our clinical pharmacist team. Indications were analysed and patients got a pharmaceutical interview whenever possible. Several months later, pharmacists recorded benefice, adverse event and patient observance from the patient follow up consultation with a neurologist. Stroke upon atrial fibrillation mainly occurred (69%) and DOA were mainly prescribed (79%). Most of the patients (73%) were informed on their treatment before leaving. The registry allowed to follow 72% patients and showed an overall compliance (98%) and few thrombotic relapses (3%) or adverse effects (10%). Our registry showed that DOA prescription is significantly chosen over VKA for patients with stroke upon atrial fibrillation. Moreover, accompanying prescription of risky drugs, such as OAC, by clinical pharmacists, with personalised information prior to discharge, is feasible, likely contributing to increase patient adherence and safety of their treatment.