Implementation of a standardised annual anticoagulation specialist review in primary care.

Primary Health Care Research & Development
Nathan W Hutchinson-JonesJosephine N Crowe

Abstract

An increasing number of patients are being prescribed direct oral anticoagulants (DOACs), while the patients who remain on warfarin are becoming more complex. There is currently a lack of a standardised anticoagulation review for patients in primary care, resulting in potentially preventable harm events. Our aim was to implement a new service, where a standardised review is carried out by a specialist multidisciplinary secondary care anticoagulation team. Overall, the implementation of a standardised review resulted in better optimisation of anticoagulation management for patients taking either a DOAC or a warfarin. Of the 172 eligible patients prescribed warfarin, 47 (27%) chose to switch a DOAC. The average time in therapeutic range for patients on warfarin before and after the pilot increased from 73.5% to 75%. Of 482 patients taking a DOAC, 35 (7%) were found to be on incorrect dose. In 32 (91%) of 35 patients, the dose was amended after notifying the patient's general practitioner. We also found a significant number of patients inappropriately prescribed concomitant medication such as antiplatelet or non-steroidal anti-inflammatory drugs, potentially putting the patients at an elevated risk of bleeding. While further resea...Continue Reading

References

Mar 14, 2001·The American Journal of Cardiology·J H Stein, P E McBride
Jun 29, 2006·British Journal of Clinical Pharmacology·R L HowardM Pirmohamed
Sep 3, 2010·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Teresa Ann WilliamsMichelle Watt
Mar 6, 2013·International Journal of Clinical Pharmacology and Therapeutics·Jan StampfussWolfgang Mueck
Jun 23, 2015·The New England Journal of Medicine·Charles V PollackJeffrey I Weitz
Jun 15, 2016·Journal of Thrombosis and Haemostasis : JTH·K MartinS Moll
Aug 29, 2017·The New England Journal of Medicine·Christopher P CannonUNKNOWN RE-DUAL PCI Steering Committee and Investigators
Oct 7, 2017·BMJ : British Medical Journal·Christopher N Floyd, Albert Ferro
Apr 29, 2018·Thrombosis Research·S GalliazzoW Ageno
Jun 22, 2018·Drugs·Young-A Heo
Jul 6, 2018·BMJ : British Medical Journal·Yana VinogradovaJulia Hippisley-Cox
Aug 18, 2018·Australian Prescriber·Jyotsna Janardan, Harry Gibbs
Oct 10, 2018·Journal of Thrombosis and Thrombolysis·Drakeria Barr, Quovadis J Epps

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