APPENDIX 1. Survey with 18 Questions and Correct Answers

DEMOGRAPHICS

1. What is your profession (check off all that apply)?

Resident/Fellow

Family physician

Internist

Emergency physician

Cardiologist

Hematologist

Thrombosis medicine specialist

Registered nurse

Nurse practitioner

Registered practical nurse

Pharmacist

Other______

2. How many years have you been in practice? (Or if you are a resident/fellow, what year of training are you in?) ______

3. What setting do you primarily work in?

Outpatient

Inpatient

Does not apply

INDICATIONS FOR ORAL ANTICOAGULANTS

For each of the questions below, select all that apply.

4. Which of the following drugs is Health Canada approved for stroke prevention in non-valvular atrial fibrillation? (Please select all that apply or all of the above)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

All of the above

Correct Answer: all of the above

5. Which of the following drugs is Health Canada approved for prevention of venous thrombosis? (Please select all that apply or all of the above)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana ®)

All of the above

Correct Answer: all of the above

6. Which of the following drugs is Health Canada approved for treatment of venous thromboembolism (DVT and/or PE)? (Please select all that apply or all of the above)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

All of the above

Do not know

Correct Answer: all of the above

7. Which of the following is a Health Canada approved indication to use direct oral anticoagulants? (Please select all that apply)

Mechanical aortic valve

Mechanical mitral valve

Heparin induced thrombocytopenia

Cerebral venous sinus thrombosis

None of the above

Do not know

Correct Answer: none of the above

DOSE ADJUSTMENT OF ORAL ANTICOAGULANTS

8. Do you adjust the dose of this drug for patients with atrial fibrillation based on renal function? (Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answers: all except warfarin

9. Do you adjust the dose of this drug for patients with atrial fibrillation based on age? (Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answers: apixaban and dabigatran

PRACTICAL USE OF ORAL ANTICOAGULANTS

10. Which of these drugs should not be removed from its original package and put in a dosette (Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answer: dabigatran

11. Which of these drugs should not be crushed before ingestion (Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answer: dabigatran

12. Which of these drugs must be taken with meals (Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answer: rivaroxaban

13. Which of these drugs can be reversed using prothrombin complex concentrate / PCC(Please select all that apply)

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answers: all except dabigatran

14. Which of these drugs has a Health Canada approved antidote (Please select all that apply)?

Warfarin / Coumadin

Dabigatran (Pradaxa®)

Rivaroxaban (Xarelto®)

Apixaban (Eliquis®)

Edoxaban (Lixiana®)

Do not know

Correct Answers: warfarin and dabigatran

COUNSELING PATIENTS ABOUT ORAL ANTICOAGULANTS

15. How often do you prescribe or dispense oral anticoagulants (including warfarin and direct oral anticoagulants)?

<5 times per month

5-10 times per month

10-20 times per month

>20 times per month

Never

16. What do you counsel patients about when you prescribe or dispense oral anticoagulants? (Please select all that apply)

Indication (e.g.,why they are taking it)

Administration (e.g., how often, what dose, take with/without meals)

Bleeding side effects

Reversal in case of bleeding or urgent surgery

Drug interactions

Food interactions

Ways to improve adherence (e.g. alarms, dosettes)

17. How comfortable do you feel about prescribing oral anticoagulants to patients?

Very uncomfortable

Uncomfortable

Comfortable

Very comfortable

18. If you feel uncomfortable or very uncomfortable, what factors contribute to this?

Lack of knowledge about appropriate dosing or administration

Lack of knowledge about appropriate indications

Lack of knowledge about interaction with other drugs

Challenges with dose adjustments required for renal impairment

Challenges with reversal/antidotes

Risk of bleeding

Other______