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AF = atrial fibrillation It has been suggested that the complex nature of warfarin prescribing has resulted in under prescribing of warfarin for stroke prevention in AF patients [ 5].
Our systematic review and meta-analysis confirm this assertion of under prescribing of real-word warfarin (median ~ 49%); however, it also suggested that warfarin utilization has been increasing somewhat over time.
In light of the findings of our study together with two smaller studies demonstrating under prescribing of statins in primary prevention of CVD, further research using individual patient level data targeting socially deprived groups, ethnic minority groups and elderly groups is indicated [ 19, 22].
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This is evidence against the suggestion that less experienced prescribers would be more likely to under-prescribe and deem medications unsafe in pregnancy [ 23].
But a Cochrane review from 2011 of studies of interventions in children with myopia concluded that the limited evidence available suggests it is better to give children the correct glasses, rather than deliberately trying to under-prescribe.
The overwhelmed ICU personnel usually under-prescribe nutritional therapy.
Despite the overwhelming consensus that pregnant women with asthma should be rigorously managed, doctors still under-prescribe.
Despite these benefits, there appears to be a tendency to under-prescribe in long-term care [ 21- 23].
As mentioned above, these observed trends can also be attributed to a propensity to under-prescribe specific types of medications according to sex.
Therefore, medical therapies that effectively reduce heart rate merit serious consideration, but are currently under-prescribed in the treatment of CAD and stable angina [ 35].
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