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The 30-day direct oral anticoagulant starter pack has simplified the treatment of acute venous thromboembolisms, but it is not appropriate for use in patients with other indications for anticoagulation. A retrospective analysis of national outpatient pharmacy claims data between January 1, 2015 and December 31, 2018, was performed. Adult patients (ages 18 years) with continuous insurance enrollment at least 12 months prior to and 1 month following a direct oral anticoagulant starter pack prescription during the study period were in