Working smarter, not harder: evaluating a population health approach to anticoagulation therapy management.

Journal of Thrombosis and Thrombolysis
Connor RossierMark E Patterson

Abstract

Inappropriate direct acting oral anti-coagulants (DOAC) prescribing increases the risk of adverse events. Population health management tools (PMTs) could help reduce adverse events through the early, efficient identification of questionable prescribing practices, but the impact of such a tool remains unknown. We evaluated the effect of PMT use on questionable DOAC dosing rates within 40 VHA medical centers and whether this effect differed by DOAC indication or agent. Medical centers were divided into PMT user or standard of care (SOC) groups based upon high or low tool access in the prior year. Questionable DOAC dosing rate was defined as the proportion of patients prescribed DOACs who were also flagged by the tool. Chi-square tests were used to determine if PMT user versus SOC groups differed with high (above 15.3%) versus low (below 15.3%) questionable dosing rates. T-tests were used to determine if mean questionable dosing rates significantly differed between the PMT user and SOC groups. DOAC PMT users were classified less frequently as being 'High" questionable dosage rate compared to SOCs (25% PMT vs. 75% SOC, respectively, p = 0.002). DOAC PMT utilization within the overall cohort was associated with a 4.3% absolute reduc...Continue Reading

References

Dec 17, 2016·Journal of the American College of Cardiology·Benjamin A SteinbergUNKNOWN ORBIT-AF Investigators and Patients
Jun 10, 2017·Journal of the American College of Cardiology·Xiaoxi YaoPeter A Noseworthy
Sep 10, 2017·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Laney K JonesMichael A Evans
May 2, 2018·JAMA : the Journal of the American Medical Association·Jonathan Skinner, Amitabh Chandra

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Citations

Nov 20, 2021·Journal of the American Heart Association·Arthur L AllenAmy Sipe

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