PT  - JOURNAL ARTICLE
AU  - Magee, Marley
AU  - Schwartz, Janice
AU  - McArthur, Amanda
AU  - Tarn, Derjung
TI  - Over-the-Counter Product-Apixaban Interactions: Patient Perspectives on Information-Seeking
AID  - 10.1370/afm.21.s1.4239
DP  - 2023 Jan 01
TA  - The Annals of Family Medicine
PG  - 4239
VI  - 21
IP  - Supplement 1
4099  - http://www.annfammed.org/content/21/Supplement_1/4239.short
4100  - http://www.annfammed.org/content/21/Supplement_1/4239.full
SO  - Ann Fam Med2023 Jan 01; 21
AB  - CONTEXT: Patients taking direct-acting oral anticoagulants (DOACs) may be at risk for bleeding if they take interacting over-the-counter (OTC) products, yet little information exists about why patients may or may not seek information about potential interactions.OBJECTIVE: To investigate perspectives of patients taking apixaban (a commonly prescribed DOAC) regarding seeking information about OTC products.STUDY DESIGN and ANALYSIS: Semi-structured interviews were analyzed using thematic analysis.SETTING: Two large academic medical centers.POPULATION: English-, Mandarin-, Cantonese-, or Spanish-speaking adults taking apixaban.OUTCOME MEASURES: Themes associated with information-seeking about potential apixaban-OTC product interactions.RESULTS: Forty-six patients aged 28-93 years (35% Asian, 15% Black, 24% Hispanic, and 20% White; 58% women), were interviewed. Respondents took 172 total OTC products, of which the most common were: vitamin D and/or calcium (15%), non-vitamin non-mineral dietary supplements (13%), acetaminophen (12%), NSAIDS/aspirin (9%), and multivitamins (9%). Themes related to lack of information-seeking about OTC products included: 1) failure to recognize that apixaban-OTC product interactions might exist; 2) beliefs that providers are responsible for disseminating information about interactions; 3) previous suboptimal interactions with providers; 4) infrequent OTC product use; and 5) lack of prior problems with OTC product use (with or without concomitant apixaban use). Conversely, themes associated with seeking information included: 1) believing that patients are responsible for their own medication-related safety; 2) greater trust in providers; 3) unfamiliarity with the OTC product; and 4) prior medication-related problems. Patients noted that information sources ranged from in-person sources (e.g., physicians, pharmacists) to online and written materials.CONCLUSIONS: Patients taking apixaban raised reasons for information-seeking about OTC products related to their perceptions of OTC products, provider-patient interactions, and their prior experiences with and frequency of OTC product use. Greater patient education about the need for information-seeking about potential DOAC-OTC product interactions may be needed at the time of prescribing.