Analysis of the trend in oral anticoagulation overdose

Aim The aim of this study is to observe trends in enquiries to the National Poisons Information Centre (NPIC) concerning oral anticoagulants over the past eleven years. Methods A retrospective review of all recorded cases involving anticoagulation enquiries to the NPIC from 2010 to 2020, inclusive, was conducted. Data included: name, type, patient demographics, location of incident, enquiry source, and type of incident, symptoms, poison severity score, and treatment. Results Four hundred and sixty five (n=465) oral anticoagulation enquiries were registered with NPIC from 2010 to 2020. Enquiries concerning anticoagulants occurred most frequently in the elderly age group (>65 years) in 47% (n=224). Most enquiries were from GP services at 46% (n=218). 1 in 10 calls involved a polypharmacy overdose. Accidental ingestion was more frequent (79%, n=105) in toddlers whereas therapeutic error occurred more frequently in elderly patients (76.1%, n=166). Majority of the cases (84%, n=396) had no symptoms at the time of the call. Only 44 (9.3%) cases received treatment. Less than 4% (n=17) required follow-up. Conclusion Anticoagulant overdose in elderly population is alarming. DOAC overdose’s is concerning as specific antidotes are not widely available. Measures should be taken to reduce the risk of polypharmacy overdose.