Characterization of Dabigatran discontinuation in the community setting

Purpose: This study documented 1) the reason for discontinuation of dabigatran therapy and 2) the time to discontinuation of therapy.

Methods: Patients were identified using adverse event reporting and by monthly hospital dispensing reports from November 2010 to February 2012.  The anticoagulation clinic records of identified patients were reviewed to further distinguish the time of initiation of therapy and followed until time of discontinuation or until the end of the study.

Results: Of the 104 patients evaluated, 24 patients (23%) discontinued dabigatran due to adverse events or side effects, 13 patients (13%) were discontinued due to no longer being a candidate, 2 patients (2%) discontinued due to price, and 2 (2%) patients discontinued due to unknown reasons.  The 24 patients that experienced side effects or adverse events were on the medication for an average of 2.88 months, ranging from 0 to 10 months.  The 13 patients that discontinued dabigatran due to no longer having an indication for its use, were on the medication for an average of 3.62 months, ranging from 0 to 13 months.  The 2 patients that discontinued dabigatran due to unknown reasons were on the medication an average of 9.5 months, ranging from 8 to 11 months.  The 2 patients that discontinued dabigatran due to medication cost, stopped taking the medication upon leaving the hospital (0 months).  Of the 63 patients that were not discontinued, the average time of therapy was 7.2 months and ranged from 1 to 16 months.

Conclusions: Most patients that experienced a side effect or adverse event, discontinued dabigatran in the first 3 months.  Follow-up with clinic physicians post discharge and monitoring patients closely for the first 3 months after initiation should be ensured.