Sanghai S, Wong C, Wang Z, et al. - Given the recommendation for dose alteration based on age, renal function, body weight, and drug‐drug interactions by direct‐acting oral anticoagulant (DOAC) dosing guidelines for atrial fibrillation, researchers sought to attain data delineating the frequency and factors linked with prescription of potentially inappropriate doses. In the ongoing SAGE‐AF (Systematic Assessment of Geriatric Elements in Atrial Fibrillation) study, participants with atrial fibrillation (age ≥ 65 years, CHA2DS2VASc ≥ 2, no anticoagulant contraindications) underwent geriatric assessments (frailty, cognitive impairment, sensory impairments, social isolation, and depression). An algorithm was generated in order to determine DOAC dose appropriateness accounting for drug‐drug interactions, age, renal function, and body weight. Anticoagulant prescription was made in 1,064 patients (aged 74±7 years; 49% women; 82% white); of these, 460 received a DOAC. Participants were (aged 74±7 years; 49% women; 82% white). Inappropriate DOAC dose was reported in a quarter (23%; n = 105) of participants. Drug‐drug interactions were commonly observed. Multivariable regression analyses revealed the following factors to be correlated with inappropriate DOAC dosing: older age, higher CHA2DS2VASc score, and history of renal failure. Perception of higher bleeding risk or presence of renal failure in addition to lack of familiarity with dosing guidelines may be the factors that affect prescription of guideline‐nonadherent doses.