Structure of polymorbidities of the digestive diseases in patients receiving direct oral anticoagulants: results of a multicenter cross-sectional pharmacoepidemiological study

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Abstract

To develop optimal strategies for protecting the gastrointestinal tract in patients using anticoagulants, and to personalize the selection of gastroprotective drugs, which can significantly differ in their mechanism of action, it is necessary to understand the structure of polymorbidities of the digestive diseases in this category of patients. Purpose: to evaluate the frequency and structure of polymorbidities of the digestive diseases in patients receiving direct oral anticoagulants (DOACs). Material and methods. A multicenter cross-sectional (one-stage) pharmacoepidemiological study was conducted (June 2021 March 2022) with the participation of 13 hospitals and 13 outpatient centers in 15 cities of Russia. The selection of patients was carried out retrospectively in accordance with the analysis of medical records and data from electronic records. Results. The study included 662 patients using DOACs. During the analysis of polymorbidities in patients, 1099 diseases of the digestive system were described, 408 (61,6%) people had one or another pathology of the gastrointestinal tract. The most common pathologies were diseases of the stomach (54,8%), esophagus (33,8%), intestines (32,2%), gallbladder and biliary tract (21,6%). Liver diseases were observed in 10,7% of patients, pancreatic pathology in 8,0%. Chronic gastritis of unspecified etiology (26,7%), atrophic gastritis (16,8%) and gastric ulcer (12,9%) prevailed among stomach diseases, while GERD and esophagitis (both 41,9%) were the most common esophageal diseases. On the part of the intestine, there was a rather high incidence of hypoand atonic constipation (22,1%) and duodenal ulcer (21,6%). 1,2% of the study participants had a history of gastrointestinal bleeding (GIB), and 38,4% had a high risk of developing GIB. Conclusion. A high incidence of polymorbidities of the digestive diseases in patients taking DOACs has been established. In this regard, it is necessary to further develop optimal strategies for protecting the gastrointestinal tract in this category of patients and to take measures to improve the awareness of doctors about the need for an appropriate approach to managing patients.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia; I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

Dr. med. habil., professor, head of the Department of therapy and polymorbid pathology named after academician M.S. Vovsi; professor of the Department of clinical pharmacology and propaedeutics of internal medicine

Irina Yu. Orlova

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia; E.O. Mukhin Municipal Clinical Hospital of the Department of Healthcare of Moscow

cardiologist at 1st Cardiology Department of E.O. Mukhin Municipal Clinical Hospital of the Department of Healthcare of Moscow, laboratory assistant at the Department of therapy and polymorbid pathology named after academician M.S. Vovsi

Alexey I. Kochetkov

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor, associate professor of the Department of therapy and polymorbid pathology named after academician M.S. Vovsi

Olga A. Polyakova

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

PhD in Medicine, assistant at the Department of therapy and polymorbid pathology named after academician M.S. Vovsi

Alexander I. Listratov

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

general practitioner of the Medical and Diagnostic Department of the University Clinical Hospital No. 1, 1-year postgraduate student of the Department of faculty therapy No. 1 of N.V. Sklifosovsky Institute of Clinical Medicine

Natalya A. Shatalova

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

assistant at the Department of therapy and polymorbid pathology named after academician M.S. Vovsi

Svetlana V. Batyukina

Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

3-year postgraduate student of the Department of therapy and polymorbid pathology named after academician M.S. Vovsi

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