Correspondence on ‘Appropriateness of antithrombotics in geriatric inpatients with atrial fibrillation: a retrospective cross-sectional study’ by Vanderstuyft et al

Vanderstuyft et al provide a much-needed snapshot of antithrombotic prescribing quality in very old inpatients with atrial fibrillation (AF) on geriatric wards in Belgium. In a cohort with a mean age of 86.5 years, high comorbidity burden and substantial prior bleeding and stroke, most patients were discharged on a direct oral anticoagulant (DOAC), frequently in reduced doses, and 85.6% of antithrombotic regimens were deemed appropriate. This is reassuring and suggests that, in a setting with embedded clinical pharmacy services, real-world practice can approach guideline-concordant care even in the oldest patients.1